Implementing a hypertension management programme in a rural area: local approaches and experiences from Ba-Vi district, Vietnam

BMC Public Health

Research Article

Viet Lan Nguyen¹  Quang Ngoc Nguyen²  Lars Weinehall³  Peter Byass³  Stig Wall³  Ruth Bonita⁴  Son Thai Pham⁵ 

[1] Department of Cardiology, Hanoi Medical University, 1 Ton-That-Tung Street, Dong-Da District, Hanoi, Vietnam;Vietnam National Heart Institute, Bach Mai Hospital, 78 Giai-Phong Avenue, Dong-Da District, Hanoi, Vietnam;Department of Cardiology, Hanoi Medical University, 1 Ton-That-Tung Street, Dong-Da District, Hanoi, Vietnam;Vietnam National Heart Institute, Bach Mai Hospital, 78 Giai-Phong Avenue, Dong-Da District, Hanoi, Vietnam;Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, SE-90187, Umeå, Sweden;Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, SE-90187, Umeå, Sweden;School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, 1142, Auckland, New Zealand;Vietnam National Heart Institute, Bach Mai Hospital, 78 Giai-Phong Avenue, Dong-Da District, Hanoi, Vietnam;Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, SE-90187, Umeå, Sweden;

关键词: Major Adverse Cardiac Event;    Behavioural Risk Factor;    Hypertension Management;    Cardiac Care;    Commune Health Station;   

DOI  :  10.1186/1471-2458-11-325

 received in 2010-11-13, accepted in 2011-05-17,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundCostly efforts have been invested to control and prevent cardiovascular diseases (CVD) and their risk factors but the ideal solutions for low resource settings remain unclear. This paper aims at summarising our approaches to implementing a programme on hypertension management in a rural commune of Vietnam.MethodsIn a rural commune, a programme has been implemented since 2006 to manage hypertensive people at the commune health station and to deliver health education on CVD risk factors to the entire community. An initial cross-sectional survey was used to screen for hypertensives who might enter the management programme. During 17 months of implementation, other people with hypertension were also followed up and treated. Data were collected from all individual medical records, including demographic factors, behavioural CVD risk factors, blood pressure levels, and number of check-ups. These data were analysed to identify factors relating to adherence to the management programme.ResultsBoth top-down and bottom-up approaches were applied to implement a hypertension management programme. The programme was able to run independently at the commune health station after 17 months. During the implementation phase, 497 people were followed up with an overall regular follow-up of 65.6% and a dropout of 14.3%. Severity of hypertension and effectiveness of treatment were the main factors influencing the decision of people to adhere to the management programme, while being female, having several behavioural CVD risk factors or a history of chronic disease were the predictors for deviating from the programme.ConclusionOur model showed the feasibility, applicability and future potential of a community-based model of comprehensive hypertension care in a low resource context using both top-down and bottom-up approaches to engage all involved partners. This success also highlighted the important roles of both local authorities and a cardiac care network, led by an outstanding cardiac referral centre.

【 授权许可】

CC BY   
© Nguyen et al; licensee BioMed Central Ltd. 2011