Evidence map›Paper›PMID 39417146›Full record

ArticlemedRxiv : the preprint server for health sciences2024

Evaluating the World Health Organization's HEARTS Model for Hypertension and Diabetes Management: A Pilot Implementation Study in Guatemala.

Irmgardt Alicia Wellmann, Luis Fernando Ayala, Taryn M Valley, Vilma Irazola, Mark D Huffman, Michele Heisler, Peter Rohloff, Rocío Donis, Eduardo Palacios, Manuel Ramírez-Zea and 1 more

Abstract readPreprint
In one paragraph

Article in medRxiv : the preprint server for health sciences, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

11 authors.

Irmgardt Alicia WellmannINCAP Research Center for Prevention of Chronic Diseases, Institute of Nutrition of Central America and Panama, Guatemala City, Guatemala.
Luis Fernando AyalaINCAP Research Center for Prevention of Chronic Diseases, Institute of Nutrition of Central America and Panama, Guatemala City, Guatemala.
Taryn M ValleyDepartment of Anthropology, University of Wisconsin-Madison, Madison, USA.
Vilma IrazolaInstitute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina.
Mark D HuffmanDepartment of Medicine and Global Health Center, Washington University in St Louis, St Louis, Missouri, USA.
Michele HeislerDepartment of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.
Peter RohloffCenter for Indigenous Health Research, Wuqu' Kawoq, Tecpán, Guatemala.
Rocío DonisNational Program for the Prevention of Chronic Non-Communicable Diseases and Cancer. Ministry of Health, Guatemala City, Guatemala.
Eduardo PalaciosNational Program for the Prevention of Chronic Non-Communicable Diseases and Cancer. Ministry of Health, Guatemala City, Guatemala.
Manuel Ramírez-ZeaINCAP Research Center for Prevention of Chronic Diseases, Institute of Nutrition of Central America and Panama, Guatemala City, Guatemala.
David FloodINCAP Research Center for Prevention of Chronic Diseases, Institute of Nutrition of Central America and Panama, Guatemala City, Guatemala.ORCID 0000-0002-4372-7387

Funding

Research BaseP30DK092926 · NIDDK · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI MARY ELLEN MICHELE HEISLER, ADESUWA B OLOMU · 2011 to 2026
$10.0M
Integrated Training For Physician-ScientistsT32GM140935 · NIGMS · UNIVERSITY OF WISCONSIN-MADISON · PI Anna Huttenlocher, Jeniel E Nett · 2021 to 2026
$6.5M
Implementation research for comprehensive cardiometabolic care in GuatemalaK23HL161271 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI David Clifford Flood · 2022 to 2026
$949k
NHLBI NIH HHS K23 HL161271NIDDK NIH HHS P30 DK092926NIGMS NIH HHS T32 GM140935
6 · The paper itself

Abstract

Background: The World Health Organization HEARTS Technical Package is a widely implemented global initiative to improve the primary care management of cardiovascular disease risk factors. The study's objective is to report outcomes from a pilot implementation trial of integrated hypertension and diabetes management based on the HEARTS model in Guatemala. Methods: We conducted a single-arm pilot implementation trial over 6 months from October 2023 to May 2024 in 11 Guatemalan Ministry of Health primary care facilities in two districts. The pilot evaluated a package of five HEARTS-aligned implementation strategies to improve the pharmacological treatment of hypertension and diabetes. The primary outcomes were feasibility and acceptability, measured through 20 structured interviews with Ministry of Health employees and by examining enrollment and retention. Secondary outcomes included a suite of implementation and clinical outcomes, including treatment rate. Results: The study enrolled 964 patients, of whom 58.8% had hypertension only, 30.4% had diabetes only, and 10.8% had both conditions. Surveys on feasibility and acceptability among Ministry of Health staff had a median score of 5.0 (IQR: 5.0 to 5.0) and 5.0 (IQR range: 4.8 to 5.0), respectively, exceeding the prespecified benchmark of ≥3.5. Both districts achieved the prespecified benchmark of enrolling ≥25 hypertension patients and ≥25 diabetes patients. Only 36% of patients attended a follow-up visit within three months, lower than the prespecified benchmark of ≥75%. M treatment rates during the pilot increased by 22.3 (95% CI: 16.2 to 28.4; P<0.001) and 3.5 (95% CI: -1.6 to 8.7; P=0.17) patients per month for hypertension and diabetes, respectively. Conclusions: Implementation of an integrated hypertension and diabetes model based on HEARTS was generally feasible and acceptable in the Ministry of Health in Guatemala. Findings can refine national scale-up in Guatemala and inform HEARTS implementation projects in other settings.

Indexed as

diabetesglobal healthGuatemalahealth policy and systems researchhypertensionimplementation researchWHO HEARTS technical package

Identifiers

PMID39417146
PMCPMC11483012

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.