The Influence of Health Systems on Hypertension Awareness, Treatment, and Control: A Systematic Literature Review

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Background:
Hypertension (HT) affects an estimated one billion people worldwide, nearly three-quarters of whom live in low- or middle-income countries (LMICs). In both developed and developing countries, only a minority of individuals with HT are adequately treated. The reasons are many but, as with other chronic diseases, they include weaknesses in health systems. We conducted a systematic review of the influence of national or regional health systems on HT awareness, treatment, and control.

Methods and Findings:
Eligible studies were those that analyzed the impact of health systems arrangements at the regional or national level on HT awareness, treatment, control, or antihypertensive medication adherence. The following databases were searched on 13th May 2013: Medline, Embase, Global Health, LILACS, Africa-Wide Information, IMSEAR, IMEMR, and WPRIM. There were no date or language restrictions. Two authors independently assessed papers for inclusion, extracted data, and assessed risk of bias. A narrative synthesis of the findings was conducted. Meta-analysis was not conducted due to substantial methodological heterogeneity in included studies. 53 studies were included, 11 of which were carried out in LMICs. Most studies evaluated health system financing and only four evaluated the effect of either human, physical, social, or intellectual resources on HT outcomes. Reduced medication co-payments were associated with improved HT control and treatment adherence, mainly evaluated in US settings. On balance, health insurance coverage was associated with improved outcomes of HT care in US settings. Having a routine place of care or physician was associated with improved HT care.

Conclusions:
This review supports the minimization of medication co-payments in health insurance plans, and although studies were largely conducted in the US, the principle is likely to apply more generally. Studies that identify and analyze complexities and links between health systems arrangements and their effects on HT management are required, particularly in LMICs.

Please see later in the article for the Editors' Summary

Vyšlo v časopise: The Influence of Health Systems on Hypertension Awareness, Treatment, and Control: A Systematic Literature Review. PLoS Med 10(7): e32767. doi:10.1371/journal.pmed.1001490
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pmed.1001490

Souhrn

Zdroje

1. IbrahimMM, DamascenoA (2012) Hypertension in developing countries. Lancet 380: 611–619.

2. LimSS, VosT, FlaxmanAD, DanaeiG, ShibuyaK, et al. (2012) A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380: 2224–2260.

3. LewingtonS, ClarkeR, QizilbashN, PetoR, CollinsR (2002) Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 360: 1903–1913.

4. PereiraM, LunetN, AzevedoA, BarrosH (2009) Differences in prevalence, awareness, treatment and control of hypertension between developing and developed countries. J Hypertens 27: 963–975.

5. PerkovicV, HuxleyR, WuY, PrabhakaranD, MacMahonS (2007) The burden of blood pressure-related disease: a neglected priority for global health. Hypertension 50: 991–997.

6. SambB, DesaiN, NishtarS, MendisS, BekedamH, et al. (2010) Prevention and management of chronic disease: a litmus test for health-systems strengthening in low-income and middle-income countries. Lancet 376: 1785–1797.

7. World Health Organization (2000) The World Health Report 2000: Health Systems: Improving Performance. World Health Organization: Geneva.

8. WalshJME, McDonaldKM, ShojaniaKG, SundaramV, NayakS, et al. (2006) Quality improvement strategies for hypertension management: a systematic review. Medical Care 44: 646–657.

9. GlynnLG, MurphyAW, SmithSM, SchroederK, FaheyT (2010) Self-monitoring and other non-pharmacological interventions to improve the management of hypertension in primary care: a systematic review. Br J Gen Pract 60: e476–e488.

10. FaheyT, SchroederK, EbrahimS (2005) Educational and organisational interventions used to improve the management of hypertension in primary care: a systematic review. Br J Gen Pract 55: 875–882.

11. MaimarisW, PerelP, Legido-QuigleyH, BalabanovaD, McKeeM (2012) Health system barriers and facilitators to hypertension detection, treatment, and control: a systematic review (protocol). PROSPERO 2012: CRD42012002864.

12. BalabanovaD, McKeeM, KorolevaN, ChikovaniI, GoguadzeK, et al. (2009) Navigating the health system: diabetes care in Georgia. Health Policy Plan 24: 46–54.

13. HopkinsonB, BalabanovaD, McKeeM, KutzinJ (2004) The human perspective on health care reform: coping with diabetes in Kyrgyzstan. Int J Health Plann Manage 19: 43–61.

14. Gilson L (2012) Health policy and systems research: a methodology reader.World Health Organization: Geneva.

15. FrenkJ (2010) The global health system: strengthening national health systems as the next step for global progress. PLoS Med 7: e1000089 doi:10.1371/journal.pmed.1000089

16. Hoffman S, Rottingen J, Bennett S, Lavis J, Edge J, et al.. (2012) A review of conceptual barriers amd opportunities facing health systems research to inform a strategy from the World Health Organization. World Health Organization: Geneva.

17. HigginsJPT, AltmanDG, GøtzschePC, JüniP, MoherD, et al. (2011) The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ 343: d5928.

18. Rees R, Harden A, Brunton G, Oliver S, Oakley A (2001) Young people and physical activity: a systematic review of barriers and facilitators. London: EPPI-Centre, Social Science Research Unit, Institute of Education, University of London.

19. Harden A, Rees R, Shepherd J, Brunton G, Oliver S, et al.. (2001) Young people and mental health: a systematic review of research on barriers and facilitators. London: EPPI-Centre, Social Science Research Unit.

20. AdamT, de SavignyD (2012) Systems thinking for strengthening health systems in LMICs: need for a paradigm shift. Health Policy Plann 27: iv1–iv3.

21. MoherD, LiberatiA, TetzlaffJ, AltmanDG (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 339: b2535.

22. OgedegbeG, HarrisonM, RobbinsL, MancusoCA, AllegranteJP (2004) Barriers and facilitators of medication adherence in hypertensive African Americans: a qualitative study. Ethn Dis 14: 3–12.

23. OsamorPE, OwumiBE (2011) Factors associated with treatment compliance in hypertension in southwest Nigeria. J Health Popul Nutr 29: 619–628.

24. KeelerEB, BrookRH, GoldbergGA, KambergCJ, NewhouseJP (1985) How free care reduced hypertension in the health insurance experiment. JAMA 254: 1926–1931.

25. ElhayanyA, VinkerS (2011) Addressing healthcare inequities in Israel by eliminating prescription drug copayments. Am J Manag Care 17: 255–259.

26. GaiY, GuNY (2009) Association between insurance gaps and continued antihypertension medication usage in a US national representative population. Am J Hypertens 22: 1276–1280.

27. HsuJ, PriceM, HuangJ, BrandR, FungV, et al. (2006) Unintended consequences of caps on medicare drug benefits. N Engl J Med 354: 2349–2359.

28. LabhardtND, BaloJR, NdamM, GrimmJJ, MangaE (2010) Task shifting to non-physician clinicians for integrated management of hypertension and diabetes in rural Cameroon: a programme assessment at two years. BMC Health Serv Res 10.

29. LiP, McElligottS, BergquistH, SchwartzJS, DoshiJA (2012) Effect of the Medicare Part D coverage gap on medication use among patients with hypertension and hyperlipidemia. Ann Intern Med 156: 776–784.

30. MaciejewskiML, BrysonCL, PerkinsM, BloughDK, CunninghamFE, et al. (2010) Increasing copayments and adherence to diabetes, hypertension, and hyperlipidemic medications. Am J Manag Care 16: E20–E34.

31. NissinenA, TuomilehtoJ, EloJ, AlasoiniA, VarvikkoP, et al. (1983) North Karelia (Finland) hypertension detection project. Five-year follow-up of hypertensive cohort. Hypertension 5: 564–572.

32. PesaJA, Van Den BosJ, GrayT, HartsigC, McQueenRB, et al. (2012) An evaluation of the impact of patient cost sharing for antihypertensive medications on adherence, medication and health care utilization, and expenditures. Patient Prefer Adherence 6: 63–72.

33. WongMCS, JiangJY, GriffithsSM (2010) Factors associated with antihypertensive drug compliance in 83 884 Chinese patients: a cohort study. J Epidemiol Community Health 64: 895–901.

34. BriesacherBA, AndradeSE, FouayziH, ChanKA (2009) Medication adherence and use of generic drug therapies. Am J Manag Care 15: 450–456.

35. SheaS, MisraD, EhrlichMH, FieldL, FrancisCK (1992) Predisposing factors for severe, uncontrolled hypertension in an inner-city minority population. N Engl J Med 327: 776–781.

36. AhluwaliaJS, McNagnySE, RaskKJ (1997) Correlates of controlled hypertension in indigent, inner-city hypertensive patients. J Gen Intern Med 12: 7–14.

37. DeVoreAD, SorrentinoM, ArnsdorfMF, WardRP, BakrisGL, et al. (2010) Predictors of hypertension control in a diverse general cardiology practice. J Clin Hypertens (Greenwich) 12: 570–577.

38. KhosraviA, MehrGK, KelishadiR, ShiraniS, GharipourM, et al. (2010) The impact of a 6-year comprehensive community trial on the awareness, treatment and control rates of hypertension in Iran: experiences from the Isfahan healthy heart program. BMC Cardiovasc Disord 10.

39. GullifordMC, MahabirD (1999) A five-year evaluation of intervention in diabetes care in Trinidad and Tobago. Diabet Med 16: 939–945.

40. TuK, Cauch-DudekK, ChenZ (2009) Comparison of primary care physician payment models in the management of hypertension. Can Fam Physician 55: 719–727.

41. BleichSN, CutlerDM, AdamsAS, LozanoR, MurrayCJL (2007) Impact of insurance and supply of health professionals on coverage of treatment for hypertension in Mexico: population based study. BMJ 335: 875–878.

42. de Santa-HelenaET, Battistella NemesMI, Eluf NetoJ (2010) Risk factors associated with non-adherence to anti-hypertensive medication among patients treated in family health care facilities. Cad Saude Publica 26: 2388–2397.

43. Mejía-RodríguezO, Paniagua-SierraR, del Refugio Valencia-OrtizM, Ruiz-GarcíaJ, Figueroa-NúñezB, et al. (2009) Factores relacionados con el descontrol de la presión arterial. Salud Publica Mex 51: 291–297.

44. DennisonCR, PeerN, SteynK, LevittNS, HillMN (2007) Determinants of hypertension care and control among peri-urban Black South Africans: The HIHI study. Ethn Dis 17: 484–491.

45. YuB, ZhangX, WangG (2013) Full coverage for hypertension drugs in rural communities in China. Am J Manag Care 19: e22–29.

46. MbouemboueOP, YiagnigniE, KoonaAK, CackoJ, NdoboP (2012) Determinants of hypertension awareness and treatment among patients under cardiology follow-up in a Cameroonian regional hospital. International Journal of Collaborative Research on Internal Medicine and Public Health 4: 1663–1672.

47. AmbawAD, AlemieGA, YohannesSMW, MengeshaZB (2012) Adherence to antihypertensive treatment and associated factors among patients on follow up at University of Gondar Hospital, Northwest Ethiopia. BMC Public Health 12: 282.

48. FedermanDG, KrishnamurthyR, KancirS, GouletJ, JusticeA (2005) Relationship between provider type and the attainment of treatment goals in primary care. Am J Manag Care 11: 561–566.

49. Fowler-BrownA, Corbie-SmithG, GarrettJ, LurieN (2007) Risk of cardiovascular events and death–does insurance matter? J Gen Intern Med 22: 502–507.

50. BrooksEL, PreisSR, HwangSJ, MurabitoJM, BenjaminEJ, et al. (2010) Health insurance and cardiovascular disease risk factors. Am J Med 123: 741–747.

51. DuruOK, VargasRB, KermahD, PanD, NorrisKC (2007) Health Insurance Status and Hypertension Monitoring and Control in the United States. Am J Hypertens 20: 348–353.

52. BenkertR, BuchholzS, PooleM (2001) Hypertension outcomes in an urban nurse-managed center. J Am Acad Nurse Pract 13: 84–89.

53. HeJ, MuntnerP, ChenJ, RoccellaEJ, StreifferRH, et al. (2002) Factors associated with hypertension control in the general population of the United States. Arch Intern Med 162: 1051–1058.

54. BautistaLE (2008) Predictors of persistence with antihypertensive therapy: Results from the NHANES. Am J Hypertens 21: 183–188.

55. MoyE, BartmanBA, WeirMR (1995) Access to hypertensive care. Effects of income, insurance, and source of care. Arch Intern Med 155: 1497–1502.

56. AngellSY, GargRK, GwynnRC, BashL, ThorpeLE, et al. (2008) Prevalence, awareness, treatment, and predictors of control of hypertension in New York City. Circ Cardiovasc Qual Outcomes 1: 46–53.

57. HillMN, BoneLR, KimMT, MillerDJ, DennisonCR, et al. (1999) Barriers to hypertension care and control in young urban black men. Am J Hypertens 12: 951–958.

58. HymanDJ, PavlikVN (2001) Characteristics of patients with uncontrolled hypertension in the United States. N Engl J Med 345: 479–486.

59. KangJH, HanHR, KimKB, KimMT (2006) Barriers to care and control of high blood pressure in Korean-American elderly. Ethn Dis 16: 145–151.

60. SheaS, MisraD, EhrlichMH, FieldL, FrancisCK (1992b) Correlates of nonadherence to hypertension treatment in an inner city minority population. American J Public Health 82: 1607–1612.

61. WyattSB, AkylbekovaEL, WoffordMR, CoadySA, WalkerER, et al. (2008) Prevalence, awareness, treatment, and control of hypertension in the Jackson Heart Study. Hypertension 51: 650–656.

62. TurnerBJ, HollenbeakC, WeinerMG, Ten HaveT, RobertsC (2009) Barriers to adherence and hypertension control in a racially diverse representative sample of elderly primary care patients. Pharmacoepidemiol Drug Saf 18: 672–681.

63. FordES, WillJC, De Proost FordMA, MokdadAH (1998) Health insurance status and cardiovascular disease risk factors among 50–64-year-old U.S. women: findings from the Third National Health and Nutrition Examination Survey. J Womens Health 7: 997–1006.

64. NguyenQC, WaddellEN, ThomasJC, HustonSL, KerkerBD, et al. (2011) Awareness, treatment, and control of hypertension and hypercholesterolemia among insured residents of New York City, 2004. Prev Chronic Dis 8: A109.

65. SchoenMD, DidomenicoRJ, ConnorSE, DischlerJE, BaumanJL (2001) Impact of the cost of prescription drugs on clinical outcomes in indigent patients with heart disease. Pharmacotherapy 21: 1455–1463.

66. YoonJ, EttnerSL (2009) Cost-sharing and adherence to antihypertensives for low and high adherers. Am J Manag Care 15: 833–840.

67. JokisaloE, KumpusaloE, EnlundH, HalonenP, TakalaJ (2002) Factors related to non-compliance with antihypertensive drug therapy. J Hum Hypertens 16: 577–583.

68. GandelmanG, AronowWS, VarmaR (2004) Prevalence of adequate blood pressure control in self-pay or medicare patients versus medicaid or private insurance patients with systemic hypertension followed in a university cardiology or general medicine clinic. Am J Cardiol 94: 815–816.

69. UdvarhelyiIS, JennisonK, PhillipsRS, EpsteinAM (1991) Comparison of the quality of ambulatory care for fee-for-service and prepaid patients. Ann Intern Med 115: 394–400.

70. SpatzES, RossJS, DesaiMM, CanavanME, KrumholzHM (2010) Beyond insurance coverage: usual source of care in the treatment of hypertension and hypercholesterolemia. Data from the 2003–2006 National Health and Nutrition Examination Survey. Am Heart J 160: 115–121.

71. NguyenQC, WaddellEN, ThomasJC, HustonSL, KerkerBD, et al. (2011) Awareness, treatment, and control of hypertension and hypercholesterolemia among insured residents of New York City, 2004. Prev Chronic Dis 8: A109.

72. VictorRG, LeonardD, HessP, BhatDG, JonesJ, et al. (2008) Factors associated with hypertension awareness, treatment, and control in Dallas County, Texas. Arch Intern Med 168: 1285–1293.

73. AhluwaliaIB, TessaroI, GreenlundKJ, FordES (2010) Factors associated with control of hypertension, hypercholesterolemia, and diabetes among low-income women in West Virginia. J Womens Health 19: 417–424.

74. YiannakopoulouEC, PapadopulosJS, CokkinosDV, MountokalakisTD (2005) Adherence to antihypertensive treatment: A critical factor for blood pressure control. Eur J Cardiovasc Prev Rehabil 12: 243–249.

75. KotchenJM, Shakoor-AbdullahB, WalkerWE, CheliusTH, HoffmannRG, et al. (1998) Hypertension control and access to medical care in the inner city. Am J Public Health 88: 1696–1699.

76. BenkertR, BuchholzS, PooleM (2001) Hypertension outcomes in an urban nurse-managed center. J Am Acad Nurse Pract 13: 84–89.

77. FreemanJD, KadiyalaS, BellJF, MartinDP (2008) The causal effect of health insurance on utilization and outcomes in adults: a systematic review of US studies. Med Care 46: 1023–1032.

78. BarronJ, WahlP, FisherM, PlauschinatC (2008) Effect of prescription copayments on adherence and treatment failure with oral antidiabetic medications. Pharmacy and Therapeutics 33: 532–553.

79. KimMY, KimJH, ChoiIK, HwangIH, KimSY (2012) Effects of having usual source of care on preventive services and chronic disease control: a systematic review. Korean J Fam Med 33: 336–345.

80. YiannakopoulouEC, PapadopulosJS, CokkinosDV, MountokalakisTD (2005) Adherence to antihypertensive treatment: A critical factor for blood pressure control. Eur J Cardiovasc Prev Rehabil 12: 243–249.

81. Austvoll-DahlgrenA, AaserudM, VistG, RamsayC, OxmanAD, et al. (2008) Pharmaceutical policies: effects of cap and co-payment on rational drug use. Cochrane Database Syst Rev CD007017.

82. Newhouse J (1993) Free for all? Lessons from the RAND Health Insurance Experiment. Cambridge: Harvard University Press.

83. GemmillMC, ThomsonS, MossialosE (2008) What impact do prescription drug charges have on efficiency and equity? Evidence from high-income countries. Int J Equity Health 7: 12.

84. LexchinJ, GrootendorstP (2004) Effects of prescription drug user fees on drug and health services use and on health status in vulnerable populations: a systematic review of the evidence. Int J Health Serv 34: 101–122.

85. Pawson R, Tilley N (1997) Realistic Evaluation. London: Sage Publications.

86. Balabanova D, Legido-Quigley H, Perel P, McKee M (2012) Guidance for rapid appraisal of hypertension care from user and health care professional perspective: toolkit for multi-country studies. London: LSHTM.