The CATCH Study: Strengthening Primary Health Care Systems to Improve Hypertension Control
Hypertension is one of the most common chronic diseases in Jamaica and when poorly controlled, it increases the risk of heart disease, stroke and kidney failure. Approximately one-third of the Jamaican population has elevated blood pressure or hypertension. Hypertension is more common in older persons, with the 2016/2017 Jamaica Health and Lifestyle Survey (JHLS-III) showing that it affected about 75% of persons over 65 years old. Jamaica ranks among the top 10 countries with the highest rates of hypertension which is concerning as many patients are not receiving adequate treatment to reduce their risk of complications from this disease (https://www.who.int/news/item/25-08-2021-more-than-700-million-people-with-untreated-hypertension).
The Caribbean and South America Team Based Strategies to Control Hypertension (CATCH) study is an NIH-sponsored implementation study to improve hypertension control in Jamaica and Colombia. After a 2-year planning phase the project has commenced a cluster randomized trial to compare the team-based care approach with usual care in hypertension management in twenty primary care clinics in Kingston and St. Andrew and St. Thomas. In addition to blood pressure control, we will also be assessing important implementation outcomes including feasibility, adoption, adaptation, sustainability and cost.
Handover of Professor Marshall Tulloch-Reid handing over a OMRON HEM-907XL Blood Pressure Monitor to Dr Susan Strachan- Johnson, Medical Officer of Health, Kingston and St. Andrew Health Department
Over the last year we have conducted several workshops on Standardized Blood Pressure Measurement and Hypertension Management Guidelines with clinic staff from the Kingston & St. Andrew and St. Thomas Health Departments. The clinics that have been selected for the cluster randomized trial have also received WHO Certified Automated Blood Pressure machines (Omron HEM- 907 XL devices). As part of the team-based strategy in the intervention clinics we are training community health aides as health coaches and providing study participants with combination hypertension medications as well as home blood pressure monitors to improve medication adherence and blood pressure control.
Handover of Omron HEM-907XL Blood Pressure Monitor by Carene Lindsay, CATCH Study Coordinator to Dr. D'Oyen Smith, Medical Officer of Health for the parish of St. Thomas
The team-based approach to hypertension care, aligns well with the Chronic Care Model which is currently being implemented by Jamaica’s Ministry of Health and Wellness (MOHW). The Chronic Care Model puts the patient at the centre of care and rallies members of the health team to support them as they work towards managing their health condition. We hope that the lessons learned from the implementation of the CATCH Study and experiences scaling it up will inform the MOHW’s efforts to improve hypertension management at a national level.
