The Health Department, as part of a national initiative, is partnering with the Institute for Global Health Innovation at Imperial College, London, to develop quality standards for the implementation of Standard Treatment Guidelines (STGs) for the screening, diagnosis and management of primary hypertension in Kerala.
A two-member team from the Imperial College has been interacting with a team of physicians and cardiologists from the State to understand the ways in which hypertension is diagnosed and managed in primary care settings.
National initiative
In 2013, the Ministry of Health and Family Welfare (MoHFW) had signed a memorandum of understanding, MoU with the NICE International of the UK to develop STGs covering several priority areas in health.
This NICE International team that had been working with India — the International Decision Support Initiative (IDSI) — has since moved to Imperial College but continues to honour the MoU.
“We worked with the STG task force set up by the MoHFW to develop STGs for 14 disease conditions. These guidelines were developed by studying existing quality national and international guidelines, conducting systematic reviews on new clinical questions and then contextualising it to suit India,” Francoise Cluzeau, Global Health and Development Group, Imperial College, told The Hindu .
This is the first national initiative of its kind to move towards evidence-based clinical practice and improving the quality of care.
“The national STG task force and the Imperial College team has prepared nine quality standards for the management of hypertension, which has already been approved by the MoHFW. For pilot implementation at the primary care level, we have now decided to adapt two of these quality standards, which can go a long way in the early detection and management of hypertension,” T. K. Suma, Professor of Medicine, Government Medical College, Alappuzha, who led the working group, said.
Accordingly, the first recommendation is that any person 18 years of age or above who comes to the subcentre or primary health centre will be routinely screened for hypertension. The second quality standard refers to the blood pressure target that a person diagnosed with hypertension has to meet.
The target BP is below 140/90 mmHg for those below 80 years and below 150/90 mmHg for those over 80 years. “Our current protocol says to screen people above 30 years for hypertension. The lowering of the age threshold for screening is very important because if we catch them young, a lot of heart attacks and strokes can be prevented,” Dr. Suma said.
Once the final draft of the quality standards is approved, the team will work on the implementation plan, training of health workers and doctors and finally, designing and rolling out a pilot.
Pilot run
The plan is to pilot run the quality standards at 10 centres in two districts — possibly Alappuzha and Thiruvananthapuram — where the e-health project integration has been smooth.
