The State could be finally getting a better grip on the control of diabetes and hypertension, thanks to a new protocol-based, patient-centred, comprehensive management strategy being piloted in four districts under the India Hypertension Management Initiative (IHMI).
High prevalence of risk factors and extremely poor control rates have continued to be the bane of the non-communicable diseases (NCD) control programme, ever since it was rolled out in 2010. Hypertension control levels are estimated at 13% and that of diabetes 16 %.
However, the IHMI rolled out in the four districts in April last has begun to yield results. In Kerala, diabetes control is also a component, along with hypertension. The Health Department has now proposed scaling up the IHMI to all 14 districts.
“A recent review of the IHMI programme shows remarkable improvement in both diabetes and hypertension control rates from the current 13% to nearly 40 % in some districts. It just goes to show that a focussed approach and patient-centric services are crucial for NCD management at the community-level,” Bipin Gopal, State Nodal Officer for NCD Control, said.
Poor doctor-patient interaction, erratic supply of NCD drugs, non-existent documentation, and inconsistent follow-up of patients have been major challenges in implementing the NCD control programme.
The IHMI envisages protocol-based management of hypertension and consistent follow-up of every patient for over an year to achieve at least 50% control rate.
The emphasis is on better patient-centric services and a standard drug protocol so that the barriers to treatment adherence can be reduced. Every patient is registered with a unique identification number and has a separate NCD treatment card, with clinical history.
An NCD appointment register helps health workers to track defaulters and bring them in for monthly review.
“Patient default rates could be brought down with the consistent tracking of every patient. The drug protocol is easy to administer and monitor. We constantly interact with patients and help them with adherence to treatment and lifestyle modifications. Record keeping and follow-up is a major activity, which has made a huge difference in disease control and the patient’s awareness and attitude to managing his disease,” Branch Immanuel, Cardio Vascular Health Officer, IHMI, in Thiruvananthapuram said.
Monitoring and tracking to ensure uninterrupted supply of protocol NCD drugs in every institution has been a major plus under the IHMI.
“The close monitoring, follow-up of patients, and systematic documentation have brought in not just accountability to NCD management, but also a vast improvement in the quality of care delivered,” said K.T. Rekha, District Nodal Officer, NCD at Kannur.