This course provides the fundamental knowledge necessary for program managers and implementors in a hypertension control program, especially in resource-limited settings. The course is interactive and includes useful tips relevant to different settings. The course should be also relevant to physicians, nurses, pharmacists, community health workers, and others who are interested in learning about hypertension diagnosis and management.
Fundamentals of Hypertension
This module—Module 1— will walk you through the fundamentals of hypertension, such as its burden and complications, and will provide you with an overview of two approaches to managing hypertension. You will learn that hypertension is a major health problem and how it can be managed, while also learning about major challenges that can make effective and efficient management of hypertension difficult. We will end with a few real-world examples of programs that have overcome those challenges and succeeded in improving hypertension management. In Modules 2 to 6, you will learn more about the diagnosis and treatment of hypertension, optimal clinic settings, use of the community as a platform of hypertension care, medication supply, and tips for effective and efficient program operation.
Basics of Hypertension Diagnosis and Management
Once a diagnosis of hypertension is confirmed, medical personnel should treat patients to reduce the risk of heart attack and stroke. In this module, we will discuss two "complementary" treatment approaches: lifestyle modifications and blood pressure-lowering medications.
Lifestyle modifications have a beneficial effect on blood pressure as well as on health in general. Since lifestyle modifications are not easy to adopt, and even more challenging to maintain, most patients with hypertension also require one or more blood pressure-lowering medications. We will learn that hypertension in most patients can be controlled by following a simple medication protocol. These protocols are especially useful in resource-limited settings since it simplifies medication procurement and treatment processes at clinics, making it feasible to implement a hypertension program in any community you serve.
Understanding these basics are essential to designing, planning, and operating successful hypertension programs.
Clinic-Based Hypertension Management
The medical clinic is the primary place where hypertension is diagnosed and managed. Although there is no established estimate, it is likely that there are more than 1 million clinics in the world. Medical clinics vary across countries and even within a country, in terms of the number and type of staff and equipment. Although each clinic is unique, several key elements make a clinic effective and efficient for hypertension care. Appropriately trained staff and adequate facilities for effective hypertension management are crucial, and most clinics may already have these in place. Also, the staff at clinics should collaborate with the patients, recognizing their needs and ensuring that the clinic is accessible to them. This concept is called “patient-centered care.” Let’s take a look at key features of clinic settings for hypertension control in this module.
Community-Based Hypertension Management
In this module, you will learn about diverse settings in the community where you may find good opportunities to control hypertension. You will also learn about task-sharing/shifting among teams of personnel with different backgrounds such as community health workers, nurses, pharmacists, physicians, and others in delivering efficient and effective care. We will provide real-world examples of community-based programs that have succeeded in improving hypertension control. You will also learn the key factors that made those hypertension programs in the community a success.
Medication Supply to Improve Blood Pressure Control
In this module, we will review the basics of the medication supply system and share some tips for monitoring and managing medication inventories. We will also identify some challenges to medication supply and discuss potential solutions. All of these are crucial for improving both medication supply and access in hypertension programs.
Improving Operational Effectiveness in Hypertension Programs
In this course thus far, you have learned key concepts for hypertension diagnosis and management, and can describe why hypertension is important and what kind of options are available to address it. However, knowledge is not enough for successful hypertension control programs. Why? Because knowledge is within each individual, and a program needs to have a number of individuals with different values and thoughts acting collaboratively and effectively towards the same goals. There are several key elements for any program (not only for hypertension) to be successfully implemented. Since there are other resources or courses that specifically and comprehensively summarize these elements, we will not cover them all in this module. We will focus on the following three that we believe are especially important: program planning, program monitoring and evaluation, and communication
My academic medical institution has a long-term partnership with a cluster of rural towns regarding the field/community-based implementation of a national hypertension prevention and control program. Part of our final medical school year/internship is...
My academic medical institution has a long-term partnership with a cluster of rural towns regarding the field/community-based implementation of a national hypertension prevention and control program. Part of our final medical school year/internship is a six week-long rotation of involvement in the said endeavor. Thus, I am particularly interested with the content and context (resource-constrained settings) of this course offering, which I hope would allow me to contribute more while deployed or integrated in the community.
This well-made, streamlined and succinct educational material is both comprehensible and considerably useful across a wide range of stakeholders – laypeople/citizens, volunteers, community health workers (CHWs), medical assistants, nurses, pharmacists, physicians, community leaders, government officials, policy advocates/experts and program managers & implementers – in the collective fight against the most epidemiologically important modifiable risk factor for health which is hypertension.
For just a total of around six hours, one can gain at least a decent level of understanding on the relevant components of planning, running and monitoring-evaluation of a hypertension program. From epidemiology, screening, diagnosis (most especially the proper manner and circumstances of blood pressure measurement, something even most physicians find challenging to address consistently) and treatment; to the maintenance of physical facilities, resources and instruments (including blood pressure measurement apparatus calibration and repair); to staffing (involving a complement of professionals, workers and volunteers), setting (community-based or clinic-based) and engagement (with community, government and/or religious leaders) considerations; to supply chain issues (from manufacturer and/or distributor to the patient); and, a welcome surprise, to organizational/executive and communications/teamwork concerns – this MOOC delivers the knowledge without alienating anyone interested in the topic. Moreover, the further reading references are all topnotch, and at least some can be used directly for various purposes the learners may have.
I have minor comments on the course, which in no way diminish the relevance and content of the material. While the deviation of this MOOC from the standard format of presentation in Coursera is highly appreciated, some issues I experienced were: (1) lagging of non-YouTube-embedded videos and (2) the progress in the weekly material (which can be scrolled from start to finish) is not tracked properly in the left-hand course directory. Furthermore, minus the final graded weekly quizzes, the course is practically inaccessible in the Coursera mobile app (I did not try the mobile browser, however). It would be great if the course material can be viewed beyond desktop/laptop computer browsers and through smartphones (using the Coursera app), the latter likely being more relevant for those working in the field/community/clinic interested in reviewing the course contents from time to time.
After completing the course, I now feel that I have a lot to offer in improving hypertension control and prevention programs that I will be participating in. All in all, I highly recommend this course to anyone interested in hypertension care – hopefully, in one way or another, learners can advocate for such activity in their local contexts, should the need for it still exists.