Thesis abstract:

«p style="text-align:justify"»Conventional care can no longer adequately combat the growing global burden of hypertension (BP ≥140/90 mmHg). In Australia, a severe shortage of general physicians is predicted by 2030, underscoring the need to empower non-physician healthcare providers, particularly pharmacists and nurses, to achieve hypertension control targets. Team-based approaches are increasingly advocated by the World Health Organization (WHO) and other global hypertension control efforts as a scalable strategy to expand hypertension care and achieve BP control among larger populations. This PhD will assess the readiness of the Australian health systems to implement team-based hypertension care (TBHC) and explore its roles in optimizing BP control. First, I will evaluate the current context of care, the policy landscape, and health system readiness for TBHC through a policy discourse analysis, involving a review of academic and grey literature followed by an implementation workshop with relevant stakeholders. Second, I will conduct in-depth interviews with physician and non-physician (pharmacists and nurses) providers to understand their perceptions and willingness towards delivering TBHC. Third, I will conduct a survey of people living with hypertension«span style="color:#1c1c1c"»—across both rural and urban settings—«/span»to understand their attitudes and beliefs towards receiving and participating in TBHC. The survey will also involve a discrete choice experiment to explore various scenarios and weigh the preferences of people with hypertension. Fourth, I will leverage large nationally representative datasets to estimate the workforce requirements of both physician and non-physician providers needed to achieve the 70% BP control target in Australia. Lastly, given that BP measurement constitutes a key constant across all stages of the hypertension care cascade and that 51% of the expenditure on hypertension management pertains to pharmacy-related costs and fees (including out-of-pocket), I will conduct a case study of pharmacies currently providing BP measurement services. I will evaluate the availability and prices of BP measurement services across pharmacies in New South Wales through web-based data extraction and telephonic inquiries. The findings from the five objectives will be used to synthesize a comprehensive strategy that can guide the optimal implementation of TBHC in the Australian context.«/p»