Addressing Noncommunicable Disease on Short-Term Medical Trips: A Longitudinal Study of Hypertension Treatment in Santo Domingo.

BACKGROUND: Noncommunicable diseases (NCDs) are the leading cause of mortality worldwide and pose complex challenges in developing nations. Short-term medical trips, which often operate independently of government and pharmaceutical companies, are in a unique position to address NCDs in developing nations. In 2010, the Dominican Aid Society of Virginia shifted the focus of their semiannual clinic to addressing NCDs in Paraíso, Santo Domingo.

OBJECTIVE: This study analyzes the longitudinal impact of a short-term medical trip on the control of hypertension in their patient population.

METHODS: Returning patients were identified through a review of medical records from 2014 and 2016. A sample of patients who only visited in either 2014 or 2016 were matched on sex and age and served as an internal comparison group. A generalized linear mixed model was applied to assess changes in blood pressure, the proportion of patients receiving blood pressure treatment, and the intensity of blood pressure treatment within and between returning and new patients over the study period.

FINDINGS: There was a significant decrease in diastolic blood pressure within returning patients. Change in systolic blood pressure was significantly different between returning and new patients, with improvement in returning patients. There was a significant increase in the proportion of new patients receiving blood pressure treatment and a higher intensity of blood pressure treatment over time. The change in the proportion of patients receiving blood pressure treatment in the new patient group was significantly higher than that of the returning patient group.

CONCLUSIONS: Short-term medical trips with a recurrent presence in a community may improve control of hypertension and other NCDs in developing nations. Further research into the impact that short-term medical trips may have on NCDs is needed.