Effectiveness of an integrated care guideline training programme (Primary Care 101) on the processes and outcomes of non-communicable chronic diseases compared with usual training and support in primary care in South Africa

Not Applicable

Completed

Conditions: Diabetes, hypertension, depression, chronic respiratory disease-Primary care management
Not Applicable

Registration Number: ISRCTN20283604

Lead Sponsor: niversity of Cape Town (South Africa)

Brief Summary: Not available

Detailed Description: Not available

Recruitment & Eligibility

Status: Completed

Sex: All

Target Recruitment: 4598

Inclusion Criteria

1.Clinics: Nurse-led fixed primary care clinics in the Eden and Overberg districts of the Western Cape province, South Africa (all clinics service around or more than 10,000 attendances per year)
2. Patients -Age more than 18 years and written consent to participate in the study
3. Four cohorts are defined. Patients may fulfill inclusion criteria for more than one cohort. Inclusion criteria based on four target chronic diseases:
3.1. Hypertension: self-reported hypertension on medication
3.2. Diabetes: self-reported diabetes on medication
3.3. Chronic respiratory disease: self-reported asthma/ chronic obstructive pulmonary disease (COPD) / chronic bronchitis/ emphysema or cough and/or difficult breathing for more than 2 weeks (not on TB treatment in the past 3 months)
3.4. Depression: CES-D 10 (Centre for Epidemiologic Studies Depression Scale) score of 10 or more

Exclusion Criteria

1. Clinics:
1.1. Clinics with less than 9,000 attendances in the year preceding randomisation
1.2. Satellite and mobile clinics
1.3. Clinics providing exclusive antiretroviral treatment services
1.4. Clinics where chronic disease care is shared with large referral centres (to limit contamination)
2. Patients:
2.1. Inability to meet the inclusion criteria
2.2. Acute and/or terminal condition precluding participation such as acquired immune deficiency syndrome (AIDS) or cancer
2.3. Psychiatric diagnoses precluding participation such as schizophrenia, dementia and other cognitive impairment measured by self report or medical history
2.4. For chronic respiratory disease: patients receiving TB treatment in the past 3 months will be excluded