This is a generic desk guide for the management of cardiovascular disease, diabetes and hypertension in adults in low-middle income countries. These guidelines and related tools are being adapted to the local health service context in country by the Ministry of Health and NGO partners through a working group process. This process should acknowledge available resources, including; staff, drugs, basic equipment, tests (and units) prior to pilot, evaluation and scale-up in country.
This desk guide is a concise “quick reference” for doctors, clinical officers, paramedics, nurses and counsellors to use when providing routine care and health education to all patients. The initial assessment pages are designed for use with any adult who presents at a primary care facility e.g. health centre or district hospital outpatient department. The objective is to enable effective opportunistic screening, diagnosis and treatment of patients with chronic noncommunicable diseases, in particular, cardiovascular disease, type 2 diabetes mellitus, hypertension and underlying risk factors.
The desk guide clearly indicates when other guidelines should be used, i.e. when the management of disease, such as acute illness, is not within the scope of this guide. It provides a systematic approach to the monitoring of patients with these diseases and the prevention and identification of complications. It clearly indicates when referral to district hospital and assessment by a more senior clinician is appropriate, in conjunction with continuing routine care at the nearest health unit. It will help to educate patients about lifestyle measures and specific treatments so individuals can take responsibility for their own care.
This document only includes brief lifestyle education messages and is accompanied by a more detailed guide on lifestyle advice and treatment support, for use by the health educator/clinician. This desk guide incorporates recommendations from WHO “Package of Essential Noncommunicable Disease Interventions (PEN) for Primary Health Care” and the IDF Global Guidelines for Type 2 Diabetes and has been produced by thorough review of current guidelines and relevant published literature.
Walley, J.; Kain, K.; Weston, R.; Graham, K. Cardiovascular disease, Type 2 diabetes and hypertension in adults. Case management desk guide. Evidence document. Generic version May 2012. COMDIS-HSD, University of Leeds, Leeds, UK (2012) 59 pp.