Hypertension and treatment outcomes in Palestine refugees in United Nations Relief and Works Agency primary health care clinics in Jordan

Abstract

Abstractobjective In six United Nations Relief and Works Agency (UNRWA) primary health care clinics in Jordan serving Palestine refugees diagnosed with hypertension, to determine the number, characteristics, programme outcomes and measures of disease control for those registered up to 30 June, 2013, and in those who attended clinic in the second quarter of 2013, the prevalence of disease-related complications between those with hypertension only and hypertension combined with diabetes mellitus.method Retrospective cohort study with programme and outcome data collected and analysed using E-Health.results There were 18 881 patients registered with hypertension with females (64%) and persons aged ≥40 years (87%) predominating. At baseline, cigarette smoking was recorded in 17%, physical inactivity in 48% and obesity in 71% of patients. 77% of all registered patients attended clinic in the second quarter of 2013; of these, 50% had hypertension and diabetes and 50% had hypertension alone; 9% did not attend the clinics and 10% were lost to follow-up. Amongst those attending clinic, 92% had their blood pressure measured, of whom 83% had blood pressure <140/90 mm Hg. There were significantly more patients with hypertension and diabetes (N = 966, 13%) who had diseaserelated complications than patients who had hypertension alone (N = 472, 6%) [OR 2.2, 95% CI 2.0-2.5], and these differences were found for both males [18% vs. 10%, OR 1.9, 95% CI 1.6-2.2] and females [11% vs. 5%, OR 2.4, 95% CI 2.1-2.9].conclusion Large numbers of Palestine refugees are being registered and treated for hypertension in UNRWA primary health care clinics in Jordan. Cohort analysis and E-Health can be used to regularly assess caseload, programme outcomes, clinic performance, blood pressure control and cumulative prevalence of disease-related complications. Current challenges include the need to increase clinic attendance and attain better control of blood pressure.

The burden of diabetes and use of diabetes care in humanitarian crises in low-income and middle-income countries

“…All studies were published between 1992 and 2018, with thirty-three published since 2011. Thirty-eight studies reported on populations affected by armed conflict, [17][18][19][20][21][22][23][24][25][27][28][29][30][31][32][33]35,36,[38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57] two reported on populations affected by natural disasters, 34,37 and one on all crisis types. 26 Thirty-four studies were conducted in the protracted crisis phase (crisis duration greater than six months), [17][18][19][20][21][22][23][24][25]…”

UNRWA’s innovative e-Health for 5 million Palestine refugees in the Near East

“…[7][8][9][10][11][12][13][14][15] The use of data extracted from UNRWA e-Health system was important to support the secondary use of the system in cohort analysis, as documented in several studies published by UNRWA HP. [25][26][27][28] conclusIons And WAy forWArd The e-Health system developed and deployed by UNRWA at its PHC facilities has proven to be an essential tool for a cost-effective, patient-centred, better healthcare quality, in addition to equitable, fair and sustainable healthcare services via such an ICT health application.…”

Monitoring treatment outcomes in patients with chronic disease: lessons from tuberculosis and HIV/AIDS care and treatment programmes

“…A similar cohort analysis approach has been used for monitoring outcomes and obtaining strategic clinic and programmatic information for patients with chronic non‐communicable disease such as diabetes mellitus and hypertension, and this in turn allows performance to be assessed and potentially improved .…”

“…The same approach to monitoring treatment outcomes through electronic medical record systems has been used for patients with diabetes mellitus and hypertension in Malawi and Jordan at the health facility level and is working well . Valuable strategic information is being collected and, as described earlier, is being used to evaluate facility‐based programme outcomes, clinic performance and cohort survival over time.…”