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Piloting the development of a cost-effective evidence-informed clinical pathway: managing hypertension in Jordanian primary care

Piloting the development of a cost-effective evidence-informed clinical pathway: managing hypertension in Jordanian primary care
Piloting the development of a cost-effective evidence-informed clinical pathway: managing hypertension in Jordanian primary care
Objectives: the UK's National Institute for Health and Clinical Excellence (NICE) and the Jordan office of the Medicines Transparency Alliance embarked on a pilot project to design an evidence-based guideline for cost-effective pharmacological treatment of essential hypertension in Jordan. The project's objectives were to directly address a major health problem for Jordan by producing a guideline; and to delineate the strengths and weaknesses of Jordan's healthcare process to allow similar future efforts to be planned more efficiently.

Methods: the pilot spanned a period of approximately 8 months. Activities were overseen by local technical and guideline development teams, as well as experts from NICE. NICE's hypertension guidelines and economic model were used as a starting point. Parameters in the economic model were adjusted according to input and feedback from local experts with regards to Jordanian physician and patient practices, resource costs, and quality of life estimates. The results of the economic model were integrated with the updated available clinical trial literature.

Results: the outputs of the economic model were used to inform recommendations, in the form of a clinical algorithm. A report of the process and the strengths and weaknesses observed was developed, and recommendations for improvements were made.

Conclusions: the pilot represented the start of what is intended to be a healthcare process change for the country of Jordan. Issues emerged which can inform strategies to ensure a more cohesive and comprehensive approach to the cost-effective use of appropriate drugs in managing chronic disease in Jordan and countries operating in a similarly resource-constrained environment. Furthermore, our pilot highlights how richer countries with relevant experience in evidence-informed healthcare policy making can assist others in strengthening their decision-making methods and processes.
hypertension, treatment guidelines, evidence-based medicine, jordan, NICE, LMIC
0266-4623
151-158
Chalkidou, K.
43772243-e8f8-46ea-9682-3c27408c8019
Lord, J.
fd3b2bf0-9403-466a-8184-9303bdc80a9a
Obeidat, N.A.
f00f67b8-90cd-4d18-812f-135669871c41
Alabbadi, I.A.
6ccc9bbc-bb72-4b63-80fd-515c375ca7e5
Stanley, A.G.
5135d859-d226-41e7-9571-7b30a2cc36bb
Bader, R.
8cd4998a-f411-45c5-bc91-aa21653b8ea1
Momani, A.
73b4edea-f780-4978-bab5-6ab9b5e7022d
O'Mahony, R.M.
0a6da8ad-ed18-4e15-9592-b69ac8116ce7
Qatami, L.
06222787-9b3c-40fa-bc3c-6c48484bc63e
Cutler, D.
58503002-c344-4b96-b12f-52e540664d08
Chalkidou, K.
43772243-e8f8-46ea-9682-3c27408c8019
Lord, J.
fd3b2bf0-9403-466a-8184-9303bdc80a9a
Obeidat, N.A.
f00f67b8-90cd-4d18-812f-135669871c41
Alabbadi, I.A.
6ccc9bbc-bb72-4b63-80fd-515c375ca7e5
Stanley, A.G.
5135d859-d226-41e7-9571-7b30a2cc36bb
Bader, R.
8cd4998a-f411-45c5-bc91-aa21653b8ea1
Momani, A.
73b4edea-f780-4978-bab5-6ab9b5e7022d
O'Mahony, R.M.
0a6da8ad-ed18-4e15-9592-b69ac8116ce7
Qatami, L.
06222787-9b3c-40fa-bc3c-6c48484bc63e
Cutler, D.
58503002-c344-4b96-b12f-52e540664d08

Chalkidou, K., Lord, J., Obeidat, N.A., Alabbadi, I.A., Stanley, A.G., Bader, R., Momani, A., O'Mahony, R.M., Qatami, L. and Cutler, D. (2011) Piloting the development of a cost-effective evidence-informed clinical pathway: managing hypertension in Jordanian primary care. International Journal of Technology Assessment in Health Care, 27 (2), 151-158. (doi:10.1017/S0266462311000122). (PMID:21473813)

Record type: Article

Abstract

Objectives: the UK's National Institute for Health and Clinical Excellence (NICE) and the Jordan office of the Medicines Transparency Alliance embarked on a pilot project to design an evidence-based guideline for cost-effective pharmacological treatment of essential hypertension in Jordan. The project's objectives were to directly address a major health problem for Jordan by producing a guideline; and to delineate the strengths and weaknesses of Jordan's healthcare process to allow similar future efforts to be planned more efficiently.

Methods: the pilot spanned a period of approximately 8 months. Activities were overseen by local technical and guideline development teams, as well as experts from NICE. NICE's hypertension guidelines and economic model were used as a starting point. Parameters in the economic model were adjusted according to input and feedback from local experts with regards to Jordanian physician and patient practices, resource costs, and quality of life estimates. The results of the economic model were integrated with the updated available clinical trial literature.

Results: the outputs of the economic model were used to inform recommendations, in the form of a clinical algorithm. A report of the process and the strengths and weaknesses observed was developed, and recommendations for improvements were made.

Conclusions: the pilot represented the start of what is intended to be a healthcare process change for the country of Jordan. Issues emerged which can inform strategies to ensure a more cohesive and comprehensive approach to the cost-effective use of appropriate drugs in managing chronic disease in Jordan and countries operating in a similarly resource-constrained environment. Furthermore, our pilot highlights how richer countries with relevant experience in evidence-informed healthcare policy making can assist others in strengthening their decision-making methods and processes.

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More information

Published date: 2011
Keywords: hypertension, treatment guidelines, evidence-based medicine, jordan, NICE, LMIC
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 382171
URI: https://eprints.soton.ac.uk/id/eprint/382171
ISSN: 0266-4623
PURE UUID: d1cbf4a4-071b-4022-a7d8-7a6269f62835
ORCID for J. Lord: ORCID iD orcid.org/0000-0003-1086-1624

Catalogue record

Date deposited: 18 Jan 2016 12:03
Last modified: 06 Jun 2018 12:20

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