Creating and Evaluating a Toolkit for Shared Medical Appointments for Hypertension Management in a Jail Setting

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There is a higher prevalence of hypertension in jail inmates than in the general population and it has been estimated that up to 50% of inmates have hypertension (Binswanger, Krueger, & Steiner, 2011). This project describes the creation of an evidence-based toolkit for clinicians that will assist in implementing the shared medical appointment approach for the treatment of hypertension in a jail in North Carolina. The toolkit prototype was created based upon the standards of the National Commission on Correctional Health Care and evidenced based literature. Two focus groups comprised of medical and correctional staff were held to discuss the feasibility and appropriateness of the toolkit for a jail setting. Some of the concerns expressed by the focus group participants included volume of participants in need of assistance to manage their hypertension versus volume the approach could serve, length of the assessment tool, and the series/number of encounters required of the shared medical appointment approach. Based on the focus group input, it is not feasible at this time to implement the shared medical appointment approach for treatment of hypertension in this jail setting. Thus, the feedback was used to revise the toolkit to create a more practical one-time clinical education model for this specific setting. The resulting product better fits the needs of the jail and its constituents at this time.

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