Improving blood pressure management in primary care

Doctor Niamh Chapman, University of Sydney

Future Leader Fellowship

Years funded: 2026 - 2029

In Australia, 1 in 3 adults have high blood pressure (BP ?140/90 mmHg, hypertension) but only 32% have it managed effectively to reduce the risk of stroke, heart disease and dementia.

My vision is to transform the way we deliver health services to improve the management of high BP by adapting services to better meet the needs of patients and healthcare providers.

At 4 years post-PhD, I have received >$5.5 million (CIA) in research funding for two large-scale research programs (AIM-1 and AIM-2 below). With this Future Leader Fellowship, I will co-adapt these programs to consider the needs and priorities of First Nations people.

AIM-1 To determine the effect of a co-designed patient education package delivered at pharmacies to lower BP compared to usual care.

Rationale. Pharmacy is an ideal setting to embed patient education to improve BP management because patients attend for BP medications, pharmacists are trained to deliver patient education, and 86% of Australian pharmacies routinely measure BP.

Method. Individual randomised controlled trial (RCT).

Funding: NSW Health ECR Grant (CIA, $747,706, 2024-2027).

AIM-2 To determine the effect of implementing a standardised approach to hypertension management on BP control in rural and remote NSW.

Rationale. The WHO standardised clinical pathway to detect, treat and control hypertension called ‘HEARTS’, has been implemented in >30 countries and is designed to be adapted to different contexts. However, there has never been an RCT of HEARTS and there is limited evidence of implementation in high-income countries or rural/remote settings.

Method. Step-wedge cluster RCT.

Funding: MRFF (CIA, $4,786,124 [under embargo], 2025-2030).

AIM-3 To co-adapt a culturally appropriate patient education package and HEARTS clinical pathway for hypertension management with First Nations Australians.

Rationale. Aboriginal and Torres Strait Islander people are more than three times as likely to develop hypertension compared to non-Indigenous Australians. The high rates of hypertension that have remained unchanged nationally, along with Indigenous health inequity, require innovative and participatory approaches.

Method. Mixed-methods co-design (workshops x3) and pilot evaluation using evidence-based frameworks co-led with Dr Andrew Goodman, an Aboriginal man and emerging research leader in the development of culturally appropriate digital health tools for First Nations communities for the management of hypertension.

Funding. Fellowship RSP will directly fund these research activities.

TRANSLATION & DISSEMINATION My program includes >$110,000 of funding committed to regular consumer engagement and consultation, preparation of plain language summaries and ongoing stakeholder engagement at all stages of research.