Implementation of World Health Organization Package of Essential Noncommunicable Disease Interventions ( WHO PEN ) for Primary Health Care in Low‐Resource Settings: A Policy Statement From the World Hypertension League

作者：Xin H. Zhang, Liu Lisheng, Norm R.C. Campbell, Mark L. Niebylski, Peter Nilsson, Daniel T. Lackland, the World Hypertension League · 发表于：Journal of Clinical Hypertension · 年份：2015 · DOI：10.1111/jch.12749 · 被引用次数：209 · 研究领域：Global Public Health Policies and Epidemiology、Health Systems, Economic Evaluations, Quality of Life、Global Health Care Issues

Noncommunicable diseases (NCDs) accounted for more than two thirds of total deaths globally and 40% of NCD deaths in patients younger than 70 years. The majority (82%) of the premature deaths were from low- and middle-income countries.1 Cost-effective interventions for the prevention and management of NCDs are available. However, these interventions are often not accessible to the poor, especially in resource-constrained settings. Because of the lack of appropriate prevention and care, many people are suffering unnecessarily from preventable NCDs and associated complications.2 The World Health Organization developed the Package of Essential Noncommunicable Disease Interventions (PEN) for Primary Health Care in Low-Resource Settings, referred to herein as WHO PEN. It is a prioritized set of cost-effective interventions, tools, and aids that make it possible to deliver an acceptable quality of care by primary care physicians and nonphysician health workers.3 Within the packages, evidence-based interventions are structured as simple flow charts with clear referral criteria in the clinical protocols. The cardiovascular disease risk prediction tool enables health workers to target those who are at the highest risk for heart attacks, strokes, amputation, and kidney failure. The integrated multifactorial risk approach is more cost-effective and improves outcomes. WHO PEN sets a minimum standard for the management of NCDs. Its implementation will increase the national capacity to int...