危地马拉的HEARTS高血压试点项目的范围和有效性
Irmgardt Alicia Wellmann1, José Javier Rodríguez1, Benilda Batzin2
1Institute of Nutrition of Central America and Panama Research Center for Prevention of Chronic Diseases Institute of Nutrition of Central America and Panama Guatemala City Guatemala Institute of Nutrition of Central America and Panama, Research Center for Prevention of Chronic Diseases, Institute of Nutrition of Central America and Panama, Guatemala City, Guatemala.
概括
世界卫生组织 世界卫生组织
科学领域:
- 心血管疾病的研究研究.
- 公共卫生干预措施 公共卫生干预措施
- 高血压管理 高血压管理
背景情况:
- 世界卫生组织的全球心脏计划 (HEARTS) 提供了一个技术包,以改善人口层面对高血压和心血管疾病风险因素的管理.
- 初级医疗保健系统对于管理高血压等慢性疾病至关重要,特别是在资源有限的环境中.
- 实施标准化,基于证据的协议对于有效的高血压控制至关重要.
研究的目的:
- 描述危地马拉卫生部 (MOH) 初级卫生保健系统内首次试点实施HEARTS技术包.
- 评估适应HEARTS战略在农村土著社区的可持续性方面的可行性和结果.
- 通过RE-AIM框架评估HEARTS干预对患者覆盖范围和血压控制的影响.
主要方法:
- 从2022年4月开始,在危地马拉三个农村土著自治市的六个初级医疗保健设施中进行了一项试点项目.
- 与HEARTS一致的策略被调整为当地可持续性.
- 使用Reach,Effectiveness,Adoption,Implementation和Maintenance (RE-AIM) 框架来衡量结果,重点关注治疗数量和血压控制指标.
主要成果:
- 实施后观察到每月高血压治疗数量的统计显著增加 (每月增加25名患者,P=.002,其次是每月增加2.4名患者,P=.005).
- 平均静缩血压显著下降 (-4.4 mmHg,P=0.028),而腹缩血压显示出非显著的下降趋势 (-0.9 mmHg,P=0.376).
- 实现血压控制 (<130/80 mmHg) 的患者比例从基线时的33.4%增加到6个月后的47.1% (调整后的变化为13.7%,P=0.027).
结论:
- 在危地马拉卫生部的初级医疗保健系统中,HEARTS模型是可行的.
- 该干预措施对患者的接触和血压控制产生了积极影响,特别是在农村,土著人口中.
- 结果支持HEARTS计划的可扩展性,以改善全国的高血压管理,覆盖大多数寻求护理的患者.
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