Abstract P465: Standardizing Hypertension Management In A Primary Care Setting In India Through A Protocol Based Model

Hypertension is a leading cause of death in India. There are numerous barriers to adequate management of hypertension in Indian healthcare settings, including therapeutic inertia and the lack of a systematic approach. Standardizing hypertension management through an evidence based model that sets thresholds for diagnosis, treatment goals, follow up intervals and choice of drugs can lead to improved management of hypertension in an individual hospital or health system. We describe the design of a model that focuses on efficacy, safety and ease of use by healthcare providers with different levels of training. The algorithm endorses a urine albumin first approach in deciding the course of antihypertensive therapy. Providers undergo training in the implementation of this model using a training guide and handout developed for this purpose. The algorithm itself can be utilized as a point of care reference by individual practitioners, hospitals, primary health centers (PHCs) and the Health and Wellness Centers (HWCs) under the Ayushman Bharat initiative. We plan to evaluate the effectiveness of our model at Shree Krishna Hospital, Gujarat, India through a quality improvement framework. The algorithm is designed to allow adaptability to individual institutional requirements in India (and similar low and middle income countries) while standardizing the basic elements of hypertension management.