Treat Arterial Hypertension and Diabetes in Rural Africa

Not Applicable

Completed

• Conditions: Diabetes; Arterial Hypertension
• Interventions: Other: Treatment contract; Other: Tracing and recall at home by a community worker; Other: Incentive

• Registration Number: NCT00744458
• Lead Sponsor: Cooperation Afrique

Brief Summary

The purpose of this study is to determine the efficacy of three different interventions to improve treatment adherence among patients with arterial hypertension or diabetes in rural Cameroon.

Detailed Description

Non communicable chronic diseases such as arterial hypertension (AH) and diabetes (DM) are a great burden for public health in Cameroon. However, outside the main cities access to appropriate diagnosis and treatment of these health-conditions is still very poor.

The Swiss NGO "Fondation Coopération Afrique" started in 2007 a program to integrate chronic disease management with focus on AH and DM into the primary health care system of peripheral non-physician health facilities in a rural area of Central Cameroon. A first evaluation after one year revealed very low treatment adherence among the newly diagnosed patients as the main challenge.

In order to improve patient's adherence we expose them randomly to one of three interventions:

The first intervention consists in a written agreement on long-lasting therapy (treatment contract). Patients get information about the importance of a regular long term treatment and personal engagement to follow treatment and clinical controls regularly.

The second intervention introduces in addition to the treatment contract a reminder system. In case of follow-up failure a community worker traces the patient to recall the visit at the health centre.

The third intervention consists of the treatment contract combined with a financial incentive in form of one month free treatment after four months of regular follow-up.

We allocated randomly one of the three interventions to each health center.

Study Timeline

• Study Start: 2008-08
• Study First Submitted: 2008-08-29
• Study First Submitted QC: 2008-08-29
• Study First Posted: 2008-09-01
• Status Verified: 2009-08
• Primary Completion: 2010-02
• Study Completion: 2010-02
• Last Update Submitted: 2010-05-26
• Last Update Posted: 2010-05-27

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 223

Inclusion Criteria

• Patients with newly diagnosed arterial hypertension or non insulin dependent diabetes type 2 which require treatment and can be treated in the health centre
• Informed consent by the patient

Exclusion Criteria

• Patient already under treatment
• Patients who need to be referred to a hospital
• No informed consent by the patient

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
1	Treatment contract	-
2	Treatment contract	-
2	Tracing and recall at home by a community worker	-
3	Treatment contract	-
3	Incentive	-

Primary Outcome Measures

Name	Time	Method
Percentage of patients with regular follow-up one year after the treatment was started	One patient year

Secondary Outcome Measures

Name	Time	Method
Percentage of missed control-visits	One patient year
Treatment response of diabetic patients (fasting blood glucose)	One patient year
Treatment response of patients with arterial hypertension (blood pressure)	One patient year

Trial Locations

Locations (1)

Medical districts of Mfou, Mbankomo Obala and Esse in Central Cameroon; 🇨🇲 Divisions of Mefou and Lékié, Central Province, Cameroon