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

Published online by Cambridge University Press:  08 April 2011

Kalipso Chalkidou ,
Joanne Lord ,
Nour A. Obeidat ,
Ibriham A. Alabbadi ,
Adrian G. Stanley ,
Rania Bader ,
Aiman Momani ,
Rachel M. O'Mahony ,
Lara Qatami  and
Derek Cutler
Kalipso Chalkidou
Affiliation:
National Institute for Health and Clinical Excellence
Joanne Lord
Affiliation:
Brunel University
Nour A. Obeidat
Affiliation:
King Hussein Institute for Biotechnology and Cancer
Ibriham A. Alabbadi
Affiliation:
University of Jordan
Adrian G. Stanley
Affiliation:
University of Leicester and University Hospitals of Leicester NHS Trust
Rania Bader
Affiliation:
Pharmaceutical Policy Consultant
Aiman Momani
Affiliation:
PharmaNet
Rachel M. O'Mahony
Affiliation:
National Clinical Guidelines Centre, Royal College of Physicians
Lara Qatami
Affiliation:
King Hussein Cancer Center
Derek Cutler
Affiliation:
National Institute for Health and Clinical Excellence
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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.

Keywords

HypertensionTreatment guidelinesEvidence-based medicineJordanNICELMIC
Type
METHODS
Information
International Journal of Technology Assessment in Health Care , Volume 27 , Issue 2 , April 2011 , pp. 151 - 158
Copyright
Copyright © Cambridge University Press 2011

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