Evaluation of a Hospital-based Hypertension Screening Program in Seven Hospitals in Thailand

Abstract

The Department of Disease Control in Thailand piloted an intervention program at seven hospitals around the country for screening hypertension during May–September 2019. The intervention focused on implementing a guideline for managing patients with raised blood pressure. The guideline included provision of a blood pressure notification and follow-up book and conducting meetings to communicate them to the hospital representative, aim for enhancing patient coverage and reducing the risks from persistent hypertension. An evaluation was conducted to assess the effectiveness of the program and identify weaknesses. The evaluation consisted of quantitative and qualitative methods. A comparison of the proportion of newly diagnosed hypertensive patients among patients who had raised blood pressure before and after implementation of the intervention was performed. Healthcare workers in each hospital were interviewed about the work process of the program. The overall proportion of newly diagnosed hypertensive patients increased by 1.1% after the intervention (range: -11.7 to 2.9%). The practice compared between pre- and post-intervention did not have difference as expected. From the qualitative interviews, healthcare workers believed that the decision to make a follow-up appointment rested solely with the physician. Physicians tended to make appointments at one month because of their high workload. Adequate orientation of the guideline and providing robust and feasible processes were essential for the program’s success. Monitoring and evaluation should be done periodically to ensure protocol adherence.

Keywords: hospital-based screening, hypertension screening, hypertension diagnosis, program evaluation