Document Type : Original Article


1 Demonstrator, Department of Community Medicine, Government Medical College, Srinagar, Jammu and Kashmir, India

2 Department of Community Medicine, Heritage Institute of Medical Sciences, Varanasi, Uttar Pradesh, India,

3 Deputy Dean, Asia Metropolitan University, Johor, Malaysia,

4 Department of Community Medicine and School of Public Health, PGIMER, Chandigarh, India


INTRODUCTION: We know that risk communication is equally important as risk identification, which
is usually not communicated properly to the patients and resulting in poor outcomes, especially in
hypertensive patients.
OBJECTIVE: Our study objective was to evolve and test a colour coded client segmentation based
public health approach to educate the community to deal with problem of hypertension.
METHODOLOGY: This cross‑sectional pilot study was done in March 2020 among purposively approached
in a primary health centre to 100 people aged above 18 years, among them 41 gave written consent for the
study and their demographic information was noted. They were given colour coded cards as per the current
blood pressure level and previous history of hypertension. On each colour coded card, specific advice
was written for that category. For all the participants, blood pressure and treatment seeking behaviour was
noted. For hypertensive patients, adherence to medication and non‑pharmacological measures was noted.
RESULTS: Mean age of the participants was 46.5 ± 13.06 years. Mean systolic blood pressure (SBP)
and diastolic blood pressure (DBP) of the participants were 135 ± 16.85 mm Hg and 86 ± 11.42
mm Hg, respectively. Among the participants, 10 (24.39%) had a known history of hypertension.
Among them, as per the blood pressure levels measured on the day of the study 50% (5) had their
blood pressure levels under control. Interestingly 16 (39%) participants were found hypertensive
DISCUSSION: It is evident from the studies that colour coded approach is used in multiple ways, in
multiple settings, for multiple diseases. To our knowledge, little focus has been given for hypertensive
disorders in the community level. We merely bother about making their risk profiling, even in the
digital age. Sometimes physicians in emergency become puzzled whenever patients collapsed in front
of them and we missed the “Golden Hour” for the treatment by searching patients’ medical details.
CONCLUSION AND RECOMMENDATIONS: The above problem can be solved by risk profiling of
chronic patients by colour coded OPD/Health cards.


1. Park K. Preventive medicine in obstetrics, paediatrics and geriatrics.
In: Park K, eds. Textbook of preventive and social medicine. 20th ed.
Jabalpur: Banarsidas Bhanot; 2009. pp 468‑71, 495‑6, 698‑702.
2. APA. APA statement on the use of colour coding. Washington,
DC: American Psychological Association ed.; 2008.
3. Deboer S, Seaver M, Broselow J. Colour coding to reduce errors.
Am J Nurs 2005;105:68‑71.
4. Oettinger MD, Finkle JP, Esserman D, Whitehead L, Spain TK,
Pattishall SR, et al. Colour‑coding improves parental understanding
of body mass index charting. Acad Pediatr 2009;9:330‑8.
5. Chaturvedi M, Nandan D, Gupta SC. Rapid assessment of
nutritional status of children in Agra district. Indian J Prev Soc
Med 2006;37:165 9.
6. WHO. Integrated Management of childhood illness (IMCI). Geneva,
Switzerland: World Health Organization; 2013. Available from: http://
7. Ramesh AC, Kumar S. Triage, monitoring, and treatment of mass
casualty events involving chemical, biological, radiological, or
nuclear agents. J Pharm Bioallied Sci 2010;2:239‑47.
8. Family Planning Services. Cycle beads for fertility awareness: A
method of natural family planning; 2013. Available from: http://www. websitehealthinfotopicssheets/pdf/
9. Government of India. National guideline on prevention,
management and control of reproductive tract infections
including sexually transmitted infections. Mumbai: Ministry of
Health and Family Welfare, Government of India Publ. 2007.
10. TBC India. Managing the RNTCP in your area. A training
course (Modules 1‑4);2011. Available from: http://tbcindia.nic.
11. JindalAK, GuptaA, GrewalVS, MahenA. Biomedical waste disposal:
A systems analysis. Med J Armed Forces India 2013;69:351‑6.
12. Turner N, Laws A, Roberts L. Assessing the effectiveness of cold chain
management for childhood vaccines. JPrim Health Care 2011;3:278‑82.
13. Ravindran J, Shamsuddin K, Selvaraju S. Did we do it right?
An evaluation of the colour coding system for antenatal care in
Malaysia. Med J Malaysia 2003;58:37‑53.
14. Phan TD, Lau KK, De Campo J. Stratification of radiological
test ordering: Its usefulness in reducing unnecessary tests with
consequential reduction in costs. Australas Radiol 2006;50:335‑8.
15. Doughman D, Fitzpatrick T. Hospital pre‑ paredness and the
terrorism alert system. J Healthc Prot Manage 2003;19:47‑54.
16. Salera‑Vieira J, Tanner J. Colour coding for multiples: A
multidisciplinary initiative to improve the safety of infant
multiples. Nurs Womens Health 2009;13:83‑4.
17. Hyland S. Does colour coded labeling reduce the risk of
medication errors? The con side. Can J Hosp Pharm 2009;62:155‑6.
18. Taylor NJ, Davison M. Inaccurate colour coding of medical gas
cylinders. Anaesthesia 2009;64:690.
19. Fabbian F, Melandri R, Borsetti G. Colour‑coding triage and
allergic reactions in an Italian ED. Am J Emerg Med 2012;30:826‑9.
20. Zohn HK. Colour coding periodontal instruments. Quintessence
Int 2010;41:591‑4.
21. Jayakrishnan B, Al‑Rawas OA. Asthma inhalers and colour
coding: Universal dots. Brit J Gen Pract 2010;60:690‑1.
22. van Hamel C, Sant P. Colour‑coding of drug packaging.
Anaesthesia 2013;68:649.
23. Blakeway E, Jabbour RJ, Baksi J, Touquet R. ECGs: Colour‑coding
for initial training. Resuscitation 2012;83:e115‑6.
24. Hattoy S, Kozakiewicz J, Seo T. Colour‑coding process for
monitoring medication beyond‑use dates. Am J Health‑Syst
Ph 2010;67:1591.
25. Struffert T, Deuerling‑Zheng Y, Engelhorn T, Kloska S, Gölitz P,
Bozzato A, et al. Monitoring of balloon test occlusion of the internal
carotid artery by parametric colour coding and perfusion imaging
within the angio suite: First results. Clin Neuroradiol 2013;23:285‑92.
26. Webster CS, Merry AF. Colour coding, drug administration error
and the systems approach to safety. Eur J Anaesth 2007;24:385‑6.
27. Fong JS. Colour coding complications. Hosp Health Network
28. Bhattacharya S, Bera OP, Singh DK, Hossain MM, Tripathi S, Boora
S, Singh A. Colour coding-based client segmentation approach: A
neglected yet powerful tool to tackle non communicable diseases
in high burden and low resource setting countries- A primary
care approach. J Family Med Prim Care 2020;9:5846-9.