Several of the Ontario Stroke Network’s abstracts were available at the Canadian Stroke Congress (CSC) 2015. Over the next few weeks, the OSN eBulletin will highlight those abstracts.
Authors: Sundquist S1, Therrien P1
Since 2012, the Ontario Stroke Network (OSN) has delivered the provincial Hypertension Management Program (HMP). The HMP is modeled on Ontario’s Chronic Disease Prevention and Management framework, and supports best practice care delivery as outlined in the Canadian Hypertension Education Program (CHEP) guidelines. The HMP goal is to improve cardiovascular disease prevention through a focus on hypertension. In 2013, the OSN undertook a comprehensive evaluation of the HMP to inform stakeholders on the effectiveness, ongoing sustainability, and feasibility for program expansion.
A mixed-methods approach was used, including a quantitative HMP data repository analysis to evaluate changes from patient baseline of blood pressure (BP), relevant lab values and risk factor self-management. The qualitative evaluation involved site visits and surveys with participating health care providers (HCPs) and enrolled patients, which further addressed experiences with program delivery.
Quantitative results showed BP reductions from baseline values in HMP patients. Statistically significant reductions were noted in systolic and diastolic BP for patients with elevated BP and those with diabetes at baseline (p values ranged from
HCPs expressed increased confidence in hypertension (HTN) diagnosis and treatment, better understanding & compliance with CHEP guidelines, improved inter-professional communication and felt successful in providing patients with the knowledge and skills for self-management of HTN. Patients reported greater confidence in abilities to monitor BP and address modifiable risk factors as a result of health information received.
Areas cited for improvement were workflow efficiencies and more effective, enhanced patient- and provider-focused resources for providing health information.
Evaluation outcomes of HMP delivery were positive overall, showing benefit for HCPs and patients with hypertension. Opportunities have been identified to explore program evolution including: improving point-of-care access to evidence and outcomes reporting for HCPs, as well as creating capacity for comparing HMP patient outcomes to population data.
1 Ontario Stroke Network, Toronto, Canada