Effect of a Primary Care-Based Chronic Disease Management Program for Hypertension Patients in South Korea
Abstract
Background: Recently, the South Korean government has adopted a primary-care-based chronic disease management program as a national task. This study aimed to evaluate this program by focusing on hypertension patients and examine the effect of this program on their health.
Methods: Overall, 863 subjects who responded to a survey and 1,716 subjects in administrative data were included. Effects of the program were evaluated based on intermediate outcomes (motivation for self-management, changes in health behavior, medical service utilization, duration of consultation with physicians, and medication compliance) and outcomes (disease management, service satisfaction, and physician–patient relationship, change of blood pressure). Furthermore, we compared study participants’ baseline systolic and diastolic blood pressure with corresponding measurements obtained at examinations conducted at 3 and 6 months after baseline measurements.
Results: Patients’ motivation for self-management of hypertension, health behaviors (smoking, drinking, and exercise), regular clinic visit, and medication compliance were improved after participating in the program. Furthermore, patients’ blood pressure levels were decreased while their satisfaction with physician-patient relationships was increased.
Conclusion: Primary-care-based chronic disease management program is effective for managing hypertension. Therefore, it is essential to reinforce the role of community-based primary care to improve the health of patients with hypertension.
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11. Saltman RB, Rico A, Boerma WGW (2006). Primary care in the driver's seat? : organizational reform in European primary care.
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17. Yoon SJ (2013) The development of model for efficient management of hypertensive patients and diabetics. Korea Centers for Disease Control & Prevention, Cheongju, Chung-cheong bukdo
18. Anonymus (2012). OECD health care quality review: Korea. Organization for Economic Cooperation and Development, Rue Andre Pascal, Paris.
19. Lim KJ (2012) Critical review on OECD health care quality report. Health Policy Forum, pp. 93-101.
20. Kim HS, Yoo BN, Lee EW (2018). Evaluation of the national chronic diseases management policy: performance and future directions. ed.
21. Starfield B (1998). Primary care: Balancing health needs, services, and technology. New York.
22. WHO (2008). The world health report 2008: Primary health care now more than ever. World Health Organization, Appia, Geneva.
23. Kim HS KH (2017). Evaluation of a pilot project for management of chronic diseases Jung-gu, Seoul. (ed)^(eds), National Evidence-based Healthcare Collaborating Agency.
24. Yim J (2012). The effects assessment of chronic care management based on primary clinics for hypertension, diabetes patients. Korea Health Promotion Institute, Jung-gu, Seoul.
25. Cheong W, Yim J, Oh DK, Im JS, Kwang PK, Park I (2013). The Effect of a Clinic Based Incentive Program on Medication Adherence among Patients with Hypertension or Diabetes Mellitus in Incheon. ed.
26. Seo JR, Bae SS (2011). The Effect of Metabolic Syndrome Management Program in a Public Health Center. ed.
27. WY L (2013). The Second Year Effectiveness Evaluation of the Gwangmyeong-si CVD Patient Registry Project. Korea Centers for Disease Control & Prevention, Cheongju, Chung-cheong BUKDO.
28. Provost S, Pineault R, Grimard D, et al (2017). Implementation of an integrated primary care cardiometabolic risk prevention and management network in Montreal: does greater coordination of care with primary care physicians have an impact on health outcomes? Health Promot Chronic Dis Prev Can, 37(4):105-113.
29. Baena CP, Olandoski M, Younge JO, et al (2014). Effects of lifestyle-related interventions on blood pressure in low and middle-income countries: systematic review and meta-analysis. J Hypertens, 32(5):961-73.
30. Pezzin LE, Feldman PH, Mongoven JM, et al (2011). Improving blood pressure control: results of home-based post-acute care interventions. J Gen Intern Med, 26(3): 280–286.
31. Friedberg JP, Rodriguez MA, Watsula ME, et al (2015). Effectiveness of a tailored behavioral intervention to improve hypertension control: primary outcomes of a randomized controlled trial. Hypertension, 65(2):440-6.
32. Shin DS, Kim CJ, Choi YJ (2016). Effects of an empowerment program for self-management among rural older adults with hypertension in South Korea. Aust J Rural Health, 24(3):213-9.
33. Duclos M, Dejager S, Postel-Vinay N, et al (2015). Physical activity in patients with type 2 diabetes and hypertension--insights into motivations and barriers from the MOBILE study. Vasc Health Risk Manag, 11:361-71.
34. Aucott L, Rothnie H, McIntyre L, et al (2009). Long-term weight loss from lifestyle intervention benefits blood pressure?: a systematic review. Hypertension, 54(4):756-62.
35. Langford AT, Solid CA, Gann LC, et al (2018). Beliefs about the causes of hypertension and associations with pro-health behaviors. Health Psychol, 37(12):1092-1101.
36. Alefishat EA, Abu Farha RK, Al-Debei MM (2017). Self-Reported Adherence among Individuals at High Risk of Metabolic Syndrome: Effect of Knowledge and Attitude. Med Princ Pract, 26(2):157-163.
37. Ahn YH, Ham OK (2016). Factors Associated With Medication Adherence Among Medical-Aid Beneficiaries With Hypertension. West J Nurs Res, 38(10):1298-312.
38. Masala G, Bendinelli B, Occhini D, et al (2017). Physical activity and blood pressure in 10,000 Mediterranean adults: The EPIC-Florence cohort. Nutr Metab Cardiovasc Dis, 27(8):670-678.
39. Bai G, Zhang J, Zhao C, et al (2017). Adherence to a healthy lifestyle and a DASH-style diet and risk of hypertension in Chinese individuals. Hypertens Res, 40(2):196-202.
2. Krumholz HM (2017). The worldwide burden of hypertension. NEJM Journal Watch Web site. https://www.jwatch.org/na43235/2017/03/23/worldwide-burden-hypertension
3. Kim HC, Cho MC (2018). Korea hypertension fact sheet 2018. Clin Hypertens, 24:13.
4. Hird TR, Zomer E, Owen AJ, et al (2019). Productivity Burden of Hypertension in Australia. Hypertension, 73(4):777-784.
5. Ataklte F, Erqou S, Kaptoge S, et al (2015). Burden of undiagnosed hypertension in sub-saharan Africa: a systematic review and meta-analysis. Hypertension, 65(2):291-8.
6. Anonymus (2016). Medical service usage statistics by region. National Health Insurance Corporation. National Health Insurance Corporation.
7. Lee SW, Lee HY, Ihm SH, et al (2017). Status of hypertension screening in the Korea National General Health Screening Program: a questionnaire survey on 210 screening centers in two metropolitan areas. Clin Hypertens, 23:23.
8. Anonymus (2017). Current states and issues in chronic diseases: Chronic Diseases Factbook. In: Prevention KCfDC. Cheongju, Chung-cheong bukdo
9. WHO (2002). Innovative care for chronic conditions: Building blocks for action. World Health Organization, Appia, Geneva
10. Joo J CJ, Kwon YJ, Lee Y, et al (2017). A qualitative study of satisfaction with the Community-based Primary Care Project among primary care patients and its efficacy. J Korean Med Assoc, 60:173-182.
11. Saltman RB, Rico A, Boerma WGW (2006). Primary care in the driver's seat? : organizational reform in European primary care.
12. Willcox S, Lewis G, Burgers J (2011). Strengthening primary care: recent reforms and achievements in Australia, England, and the Netherlands. Issue Brief (Commonw Fund), 27:1-19.
13. Anonymus (2016). Report to congress. Center for Medicare & Medicaid Innovation, Baltimore, MD.
14. Anonymus (2016). CBO's estimates of the budgetary effects of the center for Medicare & Medicaid innovation. Congressional Budget Office, Washington, DC.
15. Lee EJ KH, Kim KH (2017). Research on U.S. primary care pilot project operations: Comprehensive Primary Care Initiatives (CPC) with the Center for Medicare & Medicaid Innovation (CMMI). Evidence and Values in Healthcare, 3:151-158.
16. Morgan MW, Zamora NE, Hindmarsh MF (2007). An inconvenient truth: a sustainable healthcare system requires chronic disease prevention and management transformation. Healthc Pap, 7(4):6-23.
17. Yoon SJ (2013) The development of model for efficient management of hypertensive patients and diabetics. Korea Centers for Disease Control & Prevention, Cheongju, Chung-cheong bukdo
18. Anonymus (2012). OECD health care quality review: Korea. Organization for Economic Cooperation and Development, Rue Andre Pascal, Paris.
19. Lim KJ (2012) Critical review on OECD health care quality report. Health Policy Forum, pp. 93-101.
20. Kim HS, Yoo BN, Lee EW (2018). Evaluation of the national chronic diseases management policy: performance and future directions. ed.
21. Starfield B (1998). Primary care: Balancing health needs, services, and technology. New York.
22. WHO (2008). The world health report 2008: Primary health care now more than ever. World Health Organization, Appia, Geneva.
23. Kim HS KH (2017). Evaluation of a pilot project for management of chronic diseases Jung-gu, Seoul. (ed)^(eds), National Evidence-based Healthcare Collaborating Agency.
24. Yim J (2012). The effects assessment of chronic care management based on primary clinics for hypertension, diabetes patients. Korea Health Promotion Institute, Jung-gu, Seoul.
25. Cheong W, Yim J, Oh DK, Im JS, Kwang PK, Park I (2013). The Effect of a Clinic Based Incentive Program on Medication Adherence among Patients with Hypertension or Diabetes Mellitus in Incheon. ed.
26. Seo JR, Bae SS (2011). The Effect of Metabolic Syndrome Management Program in a Public Health Center. ed.
27. WY L (2013). The Second Year Effectiveness Evaluation of the Gwangmyeong-si CVD Patient Registry Project. Korea Centers for Disease Control & Prevention, Cheongju, Chung-cheong BUKDO.
28. Provost S, Pineault R, Grimard D, et al (2017). Implementation of an integrated primary care cardiometabolic risk prevention and management network in Montreal: does greater coordination of care with primary care physicians have an impact on health outcomes? Health Promot Chronic Dis Prev Can, 37(4):105-113.
29. Baena CP, Olandoski M, Younge JO, et al (2014). Effects of lifestyle-related interventions on blood pressure in low and middle-income countries: systematic review and meta-analysis. J Hypertens, 32(5):961-73.
30. Pezzin LE, Feldman PH, Mongoven JM, et al (2011). Improving blood pressure control: results of home-based post-acute care interventions. J Gen Intern Med, 26(3): 280–286.
31. Friedberg JP, Rodriguez MA, Watsula ME, et al (2015). Effectiveness of a tailored behavioral intervention to improve hypertension control: primary outcomes of a randomized controlled trial. Hypertension, 65(2):440-6.
32. Shin DS, Kim CJ, Choi YJ (2016). Effects of an empowerment program for self-management among rural older adults with hypertension in South Korea. Aust J Rural Health, 24(3):213-9.
33. Duclos M, Dejager S, Postel-Vinay N, et al (2015). Physical activity in patients with type 2 diabetes and hypertension--insights into motivations and barriers from the MOBILE study. Vasc Health Risk Manag, 11:361-71.
34. Aucott L, Rothnie H, McIntyre L, et al (2009). Long-term weight loss from lifestyle intervention benefits blood pressure?: a systematic review. Hypertension, 54(4):756-62.
35. Langford AT, Solid CA, Gann LC, et al (2018). Beliefs about the causes of hypertension and associations with pro-health behaviors. Health Psychol, 37(12):1092-1101.
36. Alefishat EA, Abu Farha RK, Al-Debei MM (2017). Self-Reported Adherence among Individuals at High Risk of Metabolic Syndrome: Effect of Knowledge and Attitude. Med Princ Pract, 26(2):157-163.
37. Ahn YH, Ham OK (2016). Factors Associated With Medication Adherence Among Medical-Aid Beneficiaries With Hypertension. West J Nurs Res, 38(10):1298-312.
38. Masala G, Bendinelli B, Occhini D, et al (2017). Physical activity and blood pressure in 10,000 Mediterranean adults: The EPIC-Florence cohort. Nutr Metab Cardiovasc Dis, 27(8):670-678.
39. Bai G, Zhang J, Zhao C, et al (2017). Adherence to a healthy lifestyle and a DASH-style diet and risk of hypertension in Chinese individuals. Hypertens Res, 40(2):196-202.
| Files | ||
| Issue | Vol 51 No 3 (2022) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v51i3.8939 | |
| Keywords | ||
| Hypertension Primary care; Chronic disease Education Community medicine | ||
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How to Cite
1.
Lee E-W, Kim H-S, Yoo B-N, Lee E-J, Park J-H. Effect of a Primary Care-Based Chronic Disease Management Program for Hypertension Patients in South Korea. Iran J Public Health. 2022;51(3):624-633.
