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Hypertension and treatment outcomes in P alestine refugees in U nited N ations R elief and W orks A gency primary health care clinics in J ordan
Author(s) -
Khader A.,
Farajallah L.,
Shahin Y.,
Hababeh M.,
AbuZayed I.,
Zachariah R.,
Kochi A.,
Kapur A.,
Harries A. D.,
Shaikh I.,
Seita A.
Publication year - 2014
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12356
Subject(s) - medicine , diabetes mellitus , blood pressure , population , endocrinology , environmental health
Objective In six U nited N ations R elief and W orks A gency ( UNRWA ) primary health care clinics in J ordan serving P alestine refugees diagnosed with hypertension, to determine the number, characteristics, programme outcomes and measures of disease control for those registered up to 30 J une, 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 ‐ H ealth. 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 disease‐related 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 P alestine refugees are being registered and treated for hypertension in UNRWA primary health care clinics in J ordan. C ohort analysis and E ‐ H ealth 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.