Implementing HEARTS in Guatemala

Patient participants Inclusion criteria: All non-pregnant adults aged ≥18 years with diagnoses of type 2 diabetes or hypertension who present for routine care at participating MOH primary health facilities between over a 6-month period will be included ("patient participants"). Both previously diagnosed and newly diagnosed patients will be eligible. Previously diagnosed patients will be identified by MOH primary care clinicians who take medical histories as part of routine care. Newly diagnosed patients will be identified by MOH primary care clinicians who apply diabetes and hypertension diagnostic criteria from national guidelines. Diabetes diagnostic criteria for newly diagnosed patients: fasting glucose ≥126 md/dl, two-hour post-prandial glucose ≥200 md/dl, HbA1c ≥6.5%. Hypertension diagnostic criteria for newly diagnosed patients: include systolic blood pressure ≥130 mmHg or diastolic blood pressure ≥80 mmHg. A new hypertension diagnosis must be based on the average of at least two measurements. Exclusion criteria: Participants with confirmed or suspected type 1 diabetes or who are pregnant are not managed at MOH health centers or health posts and thus will be excluded. Other participants All MOH staff (physicians, nurses, auxiliary nurses) and stakeholders on the Technical Advisory Committee will be eligible for participation in the implementation assessment of the pilot ("MOH participants").