MAPEC-Salta Project: A New Care Model for Hypertensive Patients in Primary Health Care in the City of Salta, Argentina

Carlos D. Lacunza, Liliana D. Reales, Analia V. Duré, Verónica C. Reyes, Fabiana L. Lobos, Emilia M. Aramburu, Carina F. Tapia

Abstract


Background: Hypertension (HT) is the first cause of worldwide cardiovascular morbidity and mortality. However, it is often a poorlycontrolled disease, mainly because health care systems are oriented to the attention of acute diseases. The Argentine Ministry ofHealth proposed a new model for the care of hypertensive patients called MAPEC, based on the Chronic Care Model.Objective: The aim of this study was to evaluate the impact of MAPEC implementation to improve blood pressure (BP) control,changes in lifestyle, disease knowledge and treatment adherence in hypertensive patients treated in three primary health care centersof the City of Salta, Argentina.Methods: Blood pressure was measured with a digital blood pressure monitor and the Batalla and Morisky-Green-Levine tests wereused to evaluate disease knowledge and adherence to treatment, respectively.Results: The study included 232 patients. After model implementation, significant differences (p<0.0001) were found in bloodpressure control, disease understanding, treatment adherence and changes in hygienic-dietary measures. There was a decrease inmean BP with a reduction of 12.97 (95% CI: 9.52-16.42) mm Hg and 6.93 (95% CI: 4.70-9.16) mm Hg in systolic and diastolic BP,respectively.Conclusions: There was evident improvement in the analyzed health parameters after MAPEC implementation. This model canbe easily adapted to primary health care centers at a low cost. In addition, it agrees with the 25×25 WHO targets to reduce 25%cardiovascular premature deaths by 2025.

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