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336938
Improving Sustainability of Hypertension Management by Development of a Screening Program Utilized by Short-Term Medical Teams visiting La Romana, Dominican Republic


Tuesday, November 3, 2015 : 2:50 p.m. - 3:10 p.m.

Evan Martin, The 53rd Week, Brooklyn, NY
Tristan Lutz, The 53rd Week, Brooklyn, NY
Henry C. Lin, MD, The 53rd Week, Brooklyn, NY
Lawrence C. Loh, MD, MPH, CCFP, FRCPC, The 53rd Week, Brooklyn, NY
Chang-Berm Kang, BS, The 53rd Week, Brooklyn, NY
Audio (mp3) recording Recorded Presentation (mp4)
Background: Hypertension is a chronic medical condition that occurs commonly among Haitian migrant workers living in the bateyes surrounding La Romana, Dominican Republic and is historically undertreated.  Potential barriers to effective treatment may be related to care being provided by multiple short-term volunteer organizations.  The goal of this quality improvement initiative is to develop a screening program to be implemented by all short-term medical groups to standardize an approach to hypertension recognition.

Methods: All patients had their blood pressure measured in a mobile clinic and their initial reading guided further managmenet. Medical records of 1,658 patients seen in clinics at 22 bateyes were reviewed. Based on this data, a program guiding a standardized approach to the diagnosis of hypertension is being developed  

Results: 566 (34%) patients had an elevated blood pressure reading consistent with hypertension. Only 111 (20%) patients had a repeat blood pressure measurement for proper hypertension diagnosis. 218 (13%) patients had elevated blood pressures for which they could have received treatment per HNC8, but did not. 107 (6.5%) patients did not have their blood pressure measured at all. 

Discussion/Conclusion: There is a lack of consistency in blood pressure management, which presents an intervention opportunity to improve hypertension screening. As a part of a collaborative effort with local partners, we are developing hypertension guidelines to create a screening program to be utilized by all medical teams working in the bateyes in La Romana. Such a program could beneficially impact symptoms associated with uncontrolled blood pressures and prevent development of complications.

Learning Areas:

Chronic disease management and prevention
Planning of health education strategies, interventions, and programs

Learning Objectives:
Design a screening program to improve diagnosis and management of hypertension Assess the effectiveness of screening guidelines by evaluating changes in symptoms and complications of hypertension

Keyword(s): Rural Health, Chronic Disease Management and Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the principal investigator of this Quality Improvement project. I am working with the nonprofit organization The 53rd Week who focuses on health policy and health ethics for marginalized populations. The organization currently is working on three projects and has presented at APHA conferences in the past.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4305.0: Health Disparities and Health Equity Issues Among Underserved Populations