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.

  

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.

 

Hypertension Control in Integrated HIV and chronic disease clinics in Uganda in the SEARCH study [25]

  1. aDevelopment in progress.