Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Class |
|---|---|
| International Centre for Diarrhoeal Disease Research, Bangladesh | OTHER |
| Aga Khan University | OTHER |
| University of Kelaniya | OTHER |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
High blood pressure (BP) is the leading attributable risk for cardiovascular disease (CVD). In rural South Asia, hypertension remains to be a significant public health issue with sub-optimal rates of case finding and management. A trial to investigate integrated primary care strategies to control hypertension is planned. Packaged interventions for the planned full-scale study are varying combinations of 1) home health education (HHE) by trained community health workers (CHW), 2) trained government primary health centre mid-level providers (MLP) led care and 3) trained private practitioners. The goal of the full-scale study is to test which combination of the above interventions is the most effective in lowering blood pressure among adults with hypertension in rural communities. In addition, the full-scale study aims to quantify the incremental cost- effectiveness of each approach in terms of cost per projected cardiovascular disease (CVD) disability adjusted life-years (DALYs) averted.
The rationale for conducting the feasibility study in 3 proposed South Asian countries is strong. The South Asian countries are in a unique stage of epidemiological transition with a double burden of communicable and NCDs, the latter increasing rapidly. (2) These countries also share cultural habits and social structure with an extended family system, and have largely similar population characteristics and health seeking behaviours. (10)Moreover, the rural health system in all South Asian countries relies on cadres community health workers. At the same time there are some differences. Bangladesh and Pakistan have a high proportion of people living in extreme poverty (purchasing power parity \
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Multicomponent "combination" | Experimental | Multicomponent intervention is a combination of the following 1) community health worker (CHW)- led blood pressure (BP) screening and referral to provider, plus 2) home health education (HHE) adapted to the local diet by trained CHW plus 3) trained primary health center mid-level providers (MLP) and physicians using evidence-based treatment algorithm of BP lowering in all and lipid lowering for high risk, plus 4) process-based incentives |
|
| Usual Care | No Intervention | No active intervention |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Multicomponent intervention | Other | Multicomponent intervention is a combination of the following 1) community health worker (CHW)- led blood pressure (BP) screening and referral to provider, plus 2) home health education (HHE) adapted to the local diet by trained CHW plus 3) trained primary health center mid-level providers (MLP) and physicians using evidence-based treatment algorithm of BP lowering in all and lipid lowering for high risk, plus 4) process-based incentives |
| Measure | Description | Time Frame |
|---|---|---|
| retention rate | proportion of hypertensive individuals followed up at 3 months in 3 countries | 3 months |
| Measure | Description | Time Frame |
|---|---|---|
| Fidelity measure- Proportion of providers trained | proportion of targeted providers trained in 3 countries | 3 months |
| Fidelity measure- home health education sessions delivered | Proportion of planned home health education sessions delivered in 3 countries |
Not provided
Inclusion Criteria:
Age≥ 40 years
Residing in the selected clusters
Hypertension defined either as:
Informed consent
Exclusion Criteria:
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Affiliation | Role |
|---|---|---|
| Tazeen H Jafar, MD, MPH | Duke-NUS, Singapore | Principal Investigator |
| Aliya Naheed | Initiative for Non-Communicable Diseases icddr,b, Bangladesh | Principal Investigator |
| Imtiaz Jehan | Aga Khan University | Principal Investigator |
| Asita de Silva | University of Kelaniya, Sri Lanka | Principal Investigator |
| Shah Ebrahim | London School of Hygiene and Tropical Medicine | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Initiative for Non-Communicable Diseases icddr,b | Dhaka | Mohakhali | 1212 | Bangladesh | ||
| Aga Khan University Hospital |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 27488552 | Derived | Jafar TH, Silva Ad, Naheed A, Jehan I, Liang F, Assam PN, Legido-Quigley H, Finkelstein EA, Ebrahim S, Wickremasinghe R, Alam D, Khan AH; COBRA-BPS Study Group. Control of blood pressure and risk attenuation: a public health intervention in rural Bangladesh, Pakistan, and Sri Lanka: feasibility trial results. J Hypertens. 2016 Sep;34(9):1872-81. doi: 10.1097/HJH.0000000000001014. |
Not provided
Not provided
Not provided
| ID | Term |
|---|---|
| D006973 | Hypertension |
| D002318 | Cardiovascular Diseases |
| ID | Term |
|---|---|
| D014652 | Vascular Diseases |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
|
| 3 months |
| fidelity measure 3- physician management checklist collected | proportion of expected physician management checklist collected | 3 months |
| Baseline to follow-up change in systolic blood pressure level | within clusters intra-class correlation (95% CI) pre- to post- intervention change in systolic | 3 months |
| Karachi |
| Karachi |
| 74800 |
| Pakistan |
| University of Kelaniya | Ragama | Ragama | Sri Lanka |