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RESOURCE:

Patient retention to hypertension treatment: A mixed-method study from North India

The Journal of Clinical Hypertension

Improving hypertension control requires patient retention to hypertension treatment, which requires ready access to care. This study highlights the need for improved primary care services and patient-centered services, including extended clinic hours and diagnostic facilities.

Experts from Resolve to Save Lives India analyzed patient retention rates in hypertension treatment using a mixed-method concurrent design in a North Indian district, considering socio-demographic characteristics and patient follow-up rates along with focus group discussions and in-depth interviews with health care providers and patients. Patient retention and blood pressure control were better at Health and Wellness Centers (HWCs) levels;  barriers such as medication side effects, pill burden, and limited health care access hindered patient retention and medication adherence, compromising hypertension control at higher-level facilities, notably among females.

“The decentralization process involved training, treatment protocol provision, supervision, and monitoring. Among 394,038 individuals registered with hypertension from 2018–2021, 69% were under care in 2022. Nearly half of those under care (129,720/273,355) received treatment from HWCs in 2022. Care of hypertensive individuals from district hospitals (14%), community health centres (20%), and primary health centres (24%) were decentralized to HWCs. Overall BP control rose from 20% (4,004/20,347) in 2019 to 58% (157,595/273,355) in 2022, while missed visits decreased from 61% (12,394/20,347) in 2019 to 26% (70,894/273,355) in 2022. This trend was consistent in both states. HWCs exhibited the highest BP control and the lowest missed visits throughout the study period compared to other facility types.”

Read the full study here.

Authors: Nidhi Jaswal PhDSonu Goel PhDKritika Upadhyay MPHAnupam Khungar Pathni MBBSOm Prakash Bera MPH, MBAVandana Shah LLM

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