Change of education strategy associated with slippage in Canadian hypertension awareness treatment and control rates

Tobe, Sheldon W.; Campbell, Norman R.C.; Padwal, Raj; Khan, Nadia; Singer, Júlia

doi:10.1038/s41371-021-00519-2

Cited by 5 publications

(7 citation statements)

References 19 publications

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“…Hypertension control rates in Canada were among the highest in the world up to 2010, and these rates were associated with improved national ASCVD outcomes. 68 These rates of hypertension control and improved national outcomes were attributed in part to implementation projects such as continuing professional development programs leading to a more educated and integrated health care community. 69 More recently, however, hypertension control rates in women have fallen.…”

Section: Gaps In Knowledgementioning

confidence: 99%

Canadian Cardiovascular Harmonized National Guideline Endeavour (C-CHANGE) guideline for the prevention and management of cardiovascular disease in primary care: 2022 update

Jain

Stone²,

Agarwal³

et al. 2022

CMAJ

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The goal of the Canadian Cardiovascular Harmonized National Guideline Endeavour (C-CHANGE) process is to give all Canadian health care providers easy access to a comprehensive and practical set of harmonized guideline recommendations. Clinicians claim that there are too many guidelines with too many individual recommendations to be practical and accessible for primary care; that their patients' multimorbidity requires them to access many guidelines at the same time; and that at least in the past, some of the recommendations were not harmonized and seemed contradictory. 1 Established in 2008 to address these issues, C-CHANGE produces a guideline that is a subset of recommendations chosen from guidelines developed by Canada's cardiovascular-focused guideline groups. It is designed to help clinicians formulate comprehensive treatment plans for use by all members of the health care team to address multimorbidity, as recommended by the Canadian Heart Health Strategy and Action Plan. 2 This fourth update was necessitated by recent changes to the guidelines included in previous updates and the addition of guidelines from 3 guideline groups new to the C-CHANGE process (Canadian Cardio vascular Society/Canadian Heart Rhythm Society guideline for the management of atrial fibrillation, Health Canada's Dietary Guideline and the Canadian Consensus Conference on Diagnosis and Treatment of Dementia) (Appendix 1, available at www.cmaj.ca/lookup/doi/10.1503/cmaj.220138/tab-related -content), thus increasing the comprehensiveness from the 2011, 1 2014 3 and 2018 4 versions to a total of 11 guideline groups.The Global Burden of Diseases survey identified that the risk factors accounting for the largest percentage of disabilityadjusted life-years in Canada included tobacco use, dietary factors, high body mass index (BMI), high fasting blood glucose,

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Section: Gaps In Knowledgementioning

confidence: 99%

Canadian Cardiovascular Harmonized National Guideline Endeavour (C-CHANGE) guideline for the prevention and management of cardiovascular disease in primary care: 2022 update

Jain

Stone²,

Agarwal³

et al. 2022

CMAJ

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“…Les adultes doivent aussi faire des exercices de musculation d'intensité au moins modérée, impliquant tous les groupes musculaires majeurs 2 jours par semaine ou plus, puisqu'ils procurent des bienfaits additionnels pour la santé. Les taux de maîtrise de l'hypertension au Canada ont été parmi les plus élevés au monde jusqu'en 2010; ils ont été associés à une amélioration des complications de la MCVAS à l'échelle nationale 68 . Ces taux de maîtrise de l'hypertension et l'amélioration des résultats nationaux ont été attribués à divers projets, comme des programmes de formation professionnelle continue pour une communauté médicale mieux renseignée et plus engagée 69 .…”

Section: Lacunes Dans Les Connaissancesunclassified

Ligne directrice C-CHANGE pour l’harmonisation des lignes directrices nationales de prévention et de prise en charge des maladies cardiovasculaires en contexte de soins primaires au Canada: mise à jour 2022

Jain

Stone²,

Agarwal³

et al. 2023

CMAJ

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“…In 2010, the hypertension control program integrated with BPC, and the CHS to form Hypertension Canada ( 4 ). Coincidently, many of the name brand antihypertensive drugs were losing patent protection resulting in less financial support from the pharmaceutical industry, resulting in less amplification of key messages for hypertension control and the federal government withdrew its involvement and all support from the hypertension control program ( 4 , 7 ). Nevertheless, in 2010 Hypertension Canada retained 10-fold higher funding for hypertension control than was available in the early 2000s.…”

Section: Brief History Of Hypertension Control Efforts In Canadamentioning

confidence: 99%

“…Nevertheless, in 2010 Hypertension Canada retained 10-fold higher funding for hypertension control than was available in the early 2000s. However, the newly formed Hypertension Canada removed primary care and the HSF from the oversight role of the hypertension control program and put the individual components of the previously integrated recommendations, implementation and evaluation program on an operations committee that had multiple functions competing with hypertension control (7). The support for and processes of implementation and engagement of primary care key opinion leaders and included formal ties to their national organizations (1,2,4,12,14,29).…”

Section: Brief History Of Hypertension Control Efforts In Canadamentioning

confidence: 99%

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Ups and downs of hypertension control in Canada: critical factors and lessons learned

Campbell

Padwal

Tsuyuki

et al. 2022

Revista Panamericana De Salud Pública

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As the leading risk for death, population control of increased blood pressure represents a major challenge for all countries of the Americas. In the early 1990’s, Canada had a hypertension control rate of 13%. The control rate increased to 68% in 2010, accompanied by a sharp decline in cardiovascular disease. The unprecedented improvement in hypertension control started around the year 2000 when a comprehensive program to implement annually updated hypertension treatment recommendations started. The program included a comprehensive monitoring system for hypertension control. After 2011, there was a marked decrease in emphasis on implementation and evaluation and the hypertension control rate declined, driven by a reduction in control in women from 69% to 49%. A coalition of health and scientific organizations formed in 2011 with a priority to develop advocacy positions for dietary policies to prevent and control hypertension. By 2015, the positions were adopted by most federal political parties, but implementation has been slow. This manuscript reviews key success factors and learnings. Some key success factors included having broad representation on the program steering committee, multidisciplinary engagement with substantive primary care involvement, unbiased up to date credible recommendations, development and active adaptation of education resources based on field experience, extensive implementation of primary care resources, annual review of the program and hypertension indicators and developing and emphasizing the few interventions important for hypertension control. Learnings included the need for having strong national and provincial government engagement and support, and retaining primary care organizations and clinicians in the implementation and evaluation.

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Change of education strategy associated with slippage in Canadian hypertension awareness treatment and control rates

Cited by 5 publications

References 19 publications

Canadian Cardiovascular Harmonized National Guideline Endeavour (C-CHANGE) guideline for the prevention and management of cardiovascular disease in primary care: 2022 update

Canadian Cardiovascular Harmonized National Guideline Endeavour (C-CHANGE) guideline for the prevention and management of cardiovascular disease in primary care: 2022 update

Ligne directrice C-CHANGE pour l’harmonisation des lignes directrices nationales de prévention et de prise en charge des maladies cardiovasculaires en contexte de soins primaires au Canada: mise à jour 2022

Ups and downs of hypertension control in Canada: critical factors and lessons learned

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