Table 6 Step 6: Resources to guide patient enrollment and observe the program in a pilot setting.
From: A simple six-step guide to National-Scale Hypertension Control Program implementation
Sub-step | Task | Description | General tools and templates | Country-specific examples |
---|---|---|---|---|
Step 6A | Opportunistic screening | Encourage placement of BP devices in highly trafficked areas of health care facilities so that all patients receive a BP measurement at registration. Establish new patient referral linkages from district hospital facilities to local primary care facilities. | Â | Â |
Step 6B | Manage existing HTN patients | Establish a standardized system for patient follow-up during treatment initiation and for patients with stably controlled BP. Consider implementing a team-based care model, which can alleviate shortages of medical doctors and nurses and allow more decentralized care. | Line-lists and follow-up systems to retain patients in care during treatment initiationa Standard operating procedures for implementing differentiated service delivery models for retaining stably controlled patients in carea WHO HEARTS Team-based care module [24] Task sharing with non-physician health care workers for management of blood pressure in low-income and middle-income countries [10] | Innovations to Sustain Non-Communicable Disease Services in the Context of COVID-19: Report from Pakkred District, Nonthaburi Province, Thailand [22] Community drug distribution at doorsteps: Essential health services decentralized to care for hypertensives under the India Hypertension Control Initiative [23] |
Step 6C | Community-based screening and management | Identify well-trafficked locations or events in the community where community health care workers can conduct screening. Establish new patient referral linkages and lost-to-follow-up patient retrieval process from community to local primary care facilities. Consider house-to-house hypertension screening. Consider delivering hypertension treatment in the community through a differentiated service approach that provides medications and monitoring in the community and fewer clinic visits for stably controlled patients. | Â | Hypertension Control in Integrated HIV and chronic disease clinics in Uganda in the SEARCH study [25] |