Key result
Hypertension quality improvement project lowers SBP by ~8 mm Hg in a Rohingya refugee camp.
Why the study?
Non-communicable diseases such as hypertension are leading causes of death in low- and middle-income countries, highlighting the need to create sustainable hypertension management within existing primary care during humanitarian crises.
Does a quality improvement project for a hypertension service reduce blood pressure in Rohingya refugees in a humanitarian crisis setting?
Does a quality improvement project for a hypertension service reduce blood pressure in Rohingya refugees in a humanitarian crisis setting?
Mean Difference: 8.2 (95% CI 5.4–11)
p-value: p=<0.0001
A quality improvement project successfully established a hypertension service and significantly reduced blood pressure among Rohingya refugees in a humanitarian crisis setting, though retention remains challenging.
Non-communicable diseases have overtaken communicable diseases as the most common cause of death worldwide, with the majority of these deaths in low-income and middle-income countries. Hypertension alone causes over nine million deaths per year.Since 2017, around 750 000 Rohingya refugees have fled violence in Myanmar into Cox's Bazar District in Bangladesh. We describe a quality improvement project focused on the management of hypertension in Rohingya refugees in three primary health facilities within the Rohingya refugee camps. The aim of the project was to create a sustainable hypertension service within existing primary care services.A number of plan-do-study-act cycles were performed to improve care, with methods including: creating a specialised clinic, writing a treatment algorithm, training of pharmacists, engaging community health workers and educational programmes for staff and patients.In 2020, 554 patients were engaged in the new hypertension service. Of these, 358 (64.6%) returned for follow-up at least once. Mean systolic blood pressure (BP) was 141.7 (SD 60.0) mm Hg and mean diastolic BP was 88.1 (SD 11.1) mm Hg. Patients engaged in treatment had a significant reduction of BP of 8.2 (95% CI 5.4 to 11.0)/6.0 (95% CI 4.1 to 7.9) mm Hg (p<0.0001).Our project shows that it is possible to create a hypertension service in a challenging humanitarian crisis, which can successfully improve the control of hypertension, although retention in care can be difficult.
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Hamilton et al. (2022) studied Hypertension (n=554). Quality improvement project for hypertension management was evaluated on Reduction of blood pressure (MD 8.2 mm Hg (systolic), 95% CI 5.4 to 11.0, p=<0.0001). A quality improvement project for hypertension management in a Rohingya refugee camp significantly reduced systolic blood pressure by 8.2 mm Hg (95% CI 5.4-11.0; p<0.0001).
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