Adaptation, implementation, and evaluation of the HEARTS technical package in primary health care settings in Jordan to improve the management of hypertension: a pilot study

Abstract

The majority of patients with hypertension in Jordan have uncontrolled blood pressure. This study aimed to adapt and implement the HEARTS technical package in health care centers in Jordan and evaluate its effectiveness on hypertension management and control. The HEARTS protocol was adapted and implemented in six health centers followed by training of the healthcare staff on the adapted guidelines.Patients above 18 years old who attended health centers during the study period were recruited consecutively. The blood pressure of 852 patients was monitored over 4 months, using an individual patient treatment card. At the baseline visit, the proportion of patients with uncontrolled blood pressure was 71.5%. After 4 months of the implementation of the HEARTS protocol, the proportion of patients with uncontrolled blood pressure decreased to 29.1%. Of all studied characteristics, age was the only signi cant predictor of achieving blood pressure control. Patients aged ≤ 50 had a higher rate of controlled blood pressure readings after 4 months of implementation of the HEARTS protocol compared to patients older than 60 years (OR = 1.98, 95% CI: 1.07, 3.67; P-value = 0.028). In conclusion, the implementation of the HEARTS technical package has successfully achieved better control of the blood pressure of the enrolled patients after 4 months of implementation. To achieve better control of hypertension in the general population, scaling up HEARTS technical package is strongly recommended to integrate evidence-based strategies for hypertension control into routine care. What Is Known About TopicWhat is known about topic • Jordan has a high prevalence rate of hypertension and low levels of awareness, treatment, and control among hypertensive patients.• Treatment of hypertension in primary care facilities in Jordan remains suboptimal, and only a minority of patients who are treated reach their target levels for blood pressure. What this study adds• The HEARTS Technical Package and the hypertension treatment protocol were adapted in Jordan to be used for the management of hypertension at the primary health care level • The implementation of the HEARTS technical package has successfully achieved better control of the blood pressure of patients with hypertension after 4 months of implementation.