Evaluation of the medical service provided to outpatient clinics with hypertension in two different healthcare systems in Egypt

ABSTRACT

Hypertension represents a major public health concern. It affects about a billion people worldwide and is the most common treatable risk factor for cardiovascular diseases in patients aged over 50. Large benefits, in terms of avoided cardiovascular diseases, are expected from the treatment of hypertension. The aim of this work was to asses and compares the effectiveness of treating hypertension in two different healthcare systems. 1000 hypertensive patients, 500 from each healthcare system were enrolled in this study from medical outpatient clinics located in Ain Shams University Hospitals and different National Health Insurance Hospitals in Cairo, Egypt. All patients were counseling about life style modification, number of drugs used for the treatment of hypertension, frequency of follow up rate of side effects, compliance rate, emergency room visits relating to hypertension and complications rate from hypertension. Regarding to the medical services provided to outpatient clinics with hypertension in Ain Shams University Hospitals the following remarks were noticed; more care about life style modifications, more respect is concerned to patient desire and their opinion about medication regimen and dosage form and little care about patient history or compliance. Most of physicians did not use thiazides as the first line of treatment. While, in National Health Insurance Hospitals the following remarks were noticed; the advantage of health insurance; it is free, The disadvantages of health insurance are; routine, inefficient examination of the patient, little or no counseling at all, the unavailability of most drugs and little care about patient history or compliance. Most of physicians did not use thiazides as the first line of treatment. Successful treatment of hypertension requires patient persistence and also adherence to the regimen that has been agreed on by the patient and the physician. Clinical pharmacists can play an active role in improving patient's compliance