Community-based HEARTS Intervention (Pilot)
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Hypertension
- Sponsor
- National Heart Foundation of Bangladesh
- Enrollment
- 400
- Primary Endpoint
- Enrollment proportion
- Status
- Not yet recruiting
- Last Updated
- 2 years ago
Overview
Brief Summary
The goal of this pilot study is to assess the feasibility of health system change intervention with a focus on recruitment of patients with hypertension, initiation of antihypertensive medication, and retention of patients in care at the Community Clinics (CC) with a goal of finalizing the key features of a team- and community-based intervention in rural Bangladesh.
Patients with uncomplicated hypertension will be enrolled, their medical treatment will be provided from CC by a Community Health Care Provider (CHCP) according to the telemedicine-based instruction of Medical Officer from Upazila Health Complex (UHC) with provision of referral to UHC for an in-person evaluation. Participants will be followed up periodically and their medicine will be refilled accordingly.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Patients residing in the catchment area of the selected 4 Community Clinics under selected 2 Upazila Health Complexes (UHCs)
- •Aged 18 years and older
- •Raised BP during screening \[Systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg (based on an average of minimum two measurements)\]
- •Not currently taking antihypertensive medications
- •Eligible for the HEARTS technical package, defined as not being treated for an acute illness or medical emergency and not having a terminal illness
Exclusion Criteria
- •Patients with cardiovascular diseases, chronic kidney diseases (as evident by previous laboratory report of serum creatinine or urinary protein more than ++ on dipstick test prior to the enrollment), diabetes, or BP \>180/110 mmHg (based on the mean of last two BP measurements) at screening or after 14 days of recommended lifestyle modification will be excluded and referred directly to UHC for further management
- •Pregnancy or intent to become pregnant
- •Patients who otherwise meet inclusion criteria but decline to participate in the hypertension program evaluation or do not provide written informed consent
Outcomes
Primary Outcomes
Enrollment proportion
Time Frame: 6 months from enrollment
The proportion of eligible individuals with raised BP identified at the Community Clinic (CC) who were enrolled, defined as those started on meds within 6 months of diagnosis
Short-term, intermediate, and long-term retention in care
Time Frame: 3 months from enrollment for short-term retention in care, 6 to 12 months for intermediate retention in care, and 12 to 18 months for long-term retention in care
The proportion of enrolled individuals with raised BP who had a follow-up visit within 3 months of enrollment (short-term retention in care), between 6 and 12 months (intermediate retention in care), and between 12 and 18 months (long-term retention in care)
Secondary Outcomes
- Blood pressure control(3, 6, 12, and 18 months from enrollment)