Resolve to Save Lives, New York, NY, USA.
Indian Council of Medical Research, Jabalpur, India.
J Clin Hypertens (Greenwich). 2020 Aug;22(8):1321-1327. doi: 10.1111/jch.13944. Epub 2020 Jul 20.
The India Hypertension Control Initiative (IHCI) has been implemented in public health facilities. This study assessed the perspective of private physicians (PPs) on adopting the core strategies of the IHCI in Bhopal district of Madhya Pradesh. A semi-structured interview was purposely applied to 30 PPs to obtain their opinions on standardized hypertension treatment protocols, patient-centered services, and easy-to-use information system in their private practices. Verbatim data were recorded and analyzed thematically. Only 11 PPs followed the state hypertension treatment protocol. Among the remaining 19 PPs, the major reasons for not adopting protocol were (1) limited availability of single component hypertension drugs, (2) preferences for fixed dose combinations (FDCs), and (3) fear of either losing patients due to a lack of immediate blood pressure control or causing drug-related adverse effects. None of the interviewed doctors had resources to provide patient-centered care and use a digital health information system. Overall, the interviewed doctors identified that free supply of hypertension treatment protocol drugs, inclusion of FDCs in treatment protocol, increasing number of staff for follow-up visits, and patient education, IT-based solutions for patient records, employee incentives, and need for national data sharing policies are the key actions to accelerate the adoption of IHCI strategies in the private sector. This exploratory qualitative study suggests that engagement of private sector in the IHCI is feasible. Plans to expand the IHCI to the private sector should consider ensuring the wider availability of hypertension treatment protocol drugs and developing a simple user-friendly digital platform for patient monitoring.
印度高血压控制倡议(IHCI)已在公共卫生机构中实施。本研究评估了私营医生(PPs)在中央邦博帕尔地区采用 IHCI 核心策略的观点。采用半结构化访谈方法对 30 名 PPs 进行访谈,以了解他们对标准化高血压治疗方案、以患者为中心的服务以及在私人诊所中使用易于使用的信息系统的意见。逐字记录并进行主题分析数据。只有 11 名 PPs 遵循国家高血压治疗方案。在其余 19 名 PPs 中,不采用方案的主要原因是:(1)单一成分降压药物的供应有限;(2)对固定剂量复方制剂(FDCs)的偏好;(3)担心由于缺乏即时血压控制而失去患者,或因药物相关不良反应而导致患者流失。没有接受采访的医生有资源提供以患者为中心的护理和使用数字健康信息系统。总体而言,受访医生认为,免费提供高血压治疗方案药物、将 FDC 纳入治疗方案、增加随访工作人员数量以及开展患者教育、基于 IT 的患者记录解决方案、员工激励措施以及国家数据共享政策的必要性,是加速私营部门采用 IHCI 策略的关键行动。这项探索性定性研究表明,私营部门参与 IHCI 是可行的。将 IHCI 扩展到私营部门的计划应考虑确保更广泛地提供高血压治疗方案药物,并开发简单易用的数字患者监测平台。