[HEARTS in Chile: Self-assessment of the quality of the hypertension management program in primary care, 2025A iniciativa HEARTS no Chile: autoavaliação da qualidade do programa de hipertensão arterial na atenção primária, 2025].

OBJECTIVE

To analyze the implementation status of the HEARTS initiative in Chile's primary healthcare network based on the results of self-assessment of quality in the domains fidelity, feasibility, acceptability, and effectiveness.

METHODS

A descriptive, cross-sectional study based on self-reported quality data collected between July and December 2025 from primary care teams implementing HEARTS. Of the 544 primary care centers that reported active implementation, 511 (93.9%) completed the self-assessment; relative to the national total of 602 primary care centers, coverage was 84.9%. A total of 6,233 staff members participated. The database was closed and validated on 31 March 2026, following a review of the completeness, consistency, and consolidation of reports available on the DHIS2 HEARTS platform. The domains fidelity, feasibility, acceptability, and effectiveness were evaluated.

RESULTS

The fidelity domain achieved a maturity index of 15.01/21, corresponding to level 4. Gaps were identified in treatment intensification by non-physician healthcare workers (13.2%, level 1) and in continuity of care for individuals at high cardiovascular risk (59.1%, level 3). Feasibility was 93.0%, and acceptability was 93.5%. The lowest acceptability was observed for intensification of pharmacological treatment by nurses under supervision and according to protocol (65%). The performance index scored 1.0 out of 4.0, corresponding to the "incipient" category.

CONCLUSIONS

Implementation shows advances in relation to processes, while coverage and monitoring results continue to lag behind. These findings support the need to strengthen the quality of record-keeping, longitudinal follow-up, protocol-based redistribution of tasks within the current regulatory framework, and the provision of tailored technical assistance to regions with lower maturity.