Table 1.
Operationalization of the bars of the Cascade per country.
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| BAR | BELGIUM | SLOVENIA | CAMBODIA | NOTES |
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| Prevalence | based on survey measuring SBP ≥140 mmHg OR a DBP ≥ 90 mmHa OR self-reported use of antihypertensive medication during the past two weeks OR self-reported diagnosis | no correct estimation possible of the number of people with ‘undiagnosed HTN’ and thus not of the ‘prevalence’ | based on a survey measuring SBP ≥ 140 mmHg OR DBP ≥ 90 mmHg OR self-reported diagnosis as having been told by healthcare professionals that they have HTN | Denominator: total population aged 40–79 |
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| Tested | reported that they had a BP measurement in the last 3 years | BP measure by registered nurse in the last 3 years | reported that they had a BP measurement in the last 3 years | |
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| 1. Diagnosed | reported that they have the condition ‘HTN’ | registered as ‘having the diagnosis HTN’ | reported that they were diagnosed with HTN by a healthcare professional | the cascade will start from the ‘diagnosed’ bar, with diagnosed as ‘100%’ |
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| 2. In care | followed by a healthcare professional for HTN during the past 12 months | HTN consult. in the past 12 months | get treatment/care for HTN in the past 12 months | |
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| 3. In treatment | either self-reported use of medication or following a diet to treat HTN during the past 12 months | at least one BP measure in the last 12 months | currently receiving treatment/advice for HTN prescribed by a doctor or other HC worker: Drugs (2w) /diet advice (reduce salt/lose weight/physical exercise.) | in SL there is no information available about HTN medication or non-medical treatment; because BP measure is part of the treatment protocol of HTN, this indicator is used as a proxy of treatment |
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| 4. Adhered to treatment (medication adherence) | took prescribed HTN medication last 24h (‘yes’) AND regularly (‘yes’) | adherence assessment HTN: regularly (‘yes’) AND properly (‘yes’) | MARS-5 adherence scale for HTN medication: high adherence (vs. no)b | only among patients who took HTN medication |
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| 5. Under control | having SBP <140 mmHg and DBP <90 mmHg | having SBP <140 mmHg and DBP <90 mmHg | having SBP <140 mmHg and DBP <90 mmHg | |
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Notes: aBP was measured by trained nurses during a home visit as part of the BHES fieldwork. Respondent’s SBP and DBP were determined by taking the respective averages of the last two out of three BP measurement [38]. b Participants indicate how often they engage in each of five HTN medication-adherent behaviours (e.g. “I take less than instructed”) on a 1–5 likert scale (always to never). The item scores are summed to indicate overall level of adherence. Consistent with previous research [40,41], MARS scores were then dichotomised to give low adherence (LAd, MARS score ≤21) and high adherence sub-groups (HAd, MARS score N21).