Evaluation of Fiscally Sustainable Community Hypertension Treatment Group in Rural Honduras

In March 2010, the NGO Salud Juntos (SJ) co-developed a fiscally self-sustaining hypertension group (HTN-G) in Punta Ocote, Honduras which provides medications, clinical care, education, and treatment protocols to 75 members for a monthly cost of $2.60 USD per member. Evaluation of HTN-G's effectiveness is necessary to identify appropriate changes and to gauge its potential. At monthly meetings, community health workers record blood pressures (BPs), compliance (prescribed medications taken on HTN-G meeting day), current medications, and demographic and behavioral measures using a modified WHO STEPS Survey. Data from March-November 2010 was obtained and analyzed retrospectively for HTN-G members enrolled for minimum of one month and having most recent visits in October or November (n=45). HTN-G members analyzed were enrolled from 2-9 months (mean/median:7.4667/9), and missed from 0-6 monthly visits during enrollment (mean/median:1/1). From March to November mean BP improved significantly (156.8/88.3 to 144/81.0, t-values systolic/diastolic = 0.0003/0.0034) as did compliance (50% to 96.8% of group, χ² =9.6x10^-7). Core Members, those in HTN-G for 7+ months and missing 0-2 meetings, showed significant improvements from first to most recent visit for BP (156.3/88.3 to 144.3/82.4, t-values = 0.0020/0.0132), compliance (45.2% to 93.8%, χ²=2.0x10^-8), and control (BP £140/90 – 25% to 43.8%, χ²=0.014). These statistical improvements display the promise of the HTN-G model. At current date, the HTN-G has met for eleven months continuously, testament itself to its structure and potential. Ongoing evaluation of the HTN-G as it expands will enable further investigation of scalability and proper role in broader health environments.