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| Name | Class |
|---|---|
| Inter-American Development Bank | OTHER |
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Cardiovascular diseases are increasing throughout the developing world and are the cause of almost 16.7 million deaths each year, of which 80% occur in low and middle-income countries. As more than three fourth of the global burden of cardiometabolic diseases are related to risk factors connected with lifestyles or behaviors, such as smoking, unhealthy eating, low physical activity, and harmful consumption of alcohol. This burden could be dramatically reduced by changing individual behaviors. This study is focused on interventions that are aimed to improve the adherence to treatment in cardiovascular disease (hypertension), based on a Behavioral Economics approach. Most of public policies targeted to tackle Noncommunicable diseases utilize a rational economic model of behavior.
Behavioral economics, by using insights from cognitive psychology and other social sciences, has drawn a lot of attention for its potential to increase healthy behaviors. Interventions informed by Behavioral economics principles seek to rearrange the social or physical environment in such a way to 'nudge' people towards healthier choices and behaviors. This is an individual controlled randomized trial which will be conducted to assess whether the implementation of two strategies, blood pressure self-monitoring plus signing a "contract of commitment", and peer mentoring are effective to reduce blood pressure values over a period of 3 months, compared to usual care. This randomized trial will enroll 430 patients from 10 public primary care clinics in Argentina.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Peer mentoring | Experimental | Peers will be patients with hypertension that have already been adequately controlled within the last six months. They will be selected within each center by the staff of the center and invited to participate in the study. |
|
| Self-monitoring | Experimental | Each participant will receive a blood pressure monitor. The study nurse will teach the participant on how to use the device. |
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| Control | No Intervention | Usual care |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Peer mentoring | Behavioral | Peers will be assigned to participants according to common socio-demographic characteristics. Each peer will be assigned up to 5 participants. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Blood pressure | Net change in blood pressure levels from baseline to the end of follow-up in in each group. | 3 months |
| Measure | Description | Time Frame |
|---|---|---|
| Controlled hypertension | Proportion of patients with controlled hypertension (Systolic blood pressure <140 mm Hg and diastolic blood pressure <90 mm Hg) | 3 months |
| Adherence to antihypertensive medication |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Vilma Irazola, MD, PhD | Institute for Clinical Effectiveness and Health Policy | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Centro Asistencial Modelo Don Bosco | Quilmes | Buenos Aires | Argentina | |||
| Policlínico Julio Méndez |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 37431737 | Derived | Nejamis A, Chaparro M, Gibbons L, Poggio R, Moyano DL, Irazola V. Effectiveness of peer mentoring and self-monitoring to improve blood pressure control in a vulnerable population in Argentina: Pragmatic randomized open-label controlled trial. Chronic Illn. 2024 Dec;20(4):684-698. doi: 10.1177/17423953231187170. Epub 2023 Jul 11. |
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| Self-monitoring | Behavioral | Along with providing patients with a BP monitor, a "commitment contract" will be signed, in which participants commit themselves to measure their blood pressure at home at least once a week during the 3 months of the intervention. Each participant will be given a form to weekly recording their blood pressure values. |
|
Proportion of patients who had adhered to antihypertensive medication according to the Morisky Green Scale.
| 3 months |
| Intensification of antihypertensive medication | Proportion of patients who increased the number of antihypertensive medications or increase the dose of their antihypertensive medication. | 3 months |
| Visits to the clinic | Number of visits to the clinic over the 3 month period of follow-up. | 3 months |
| Quilmes |
| Buenos Aires |
| Argentina |
| UAP Illia | Vicente López | Buenos Aires | Argentina |
| UAP Sargento Cabral | Vicente López | Buenos Aires | Argentina |
| CAPS 1 Simeon Payba | Paso de los Libres | Corrientes Province | Argentina |
| CAPS 10 Plurianual | Paso de los Libres | Corrientes Province | Argentina |
| Centro de Atención Primaria de la Salud Dr. Balbastro | Corrientes | Argentina |
| Centro de Atención Primaria de la Salud N°15 Illia | Corrientes | Argentina |
| Centro de Salud nº 60 - El Mirador | Salta | Argentina |
| Centro de Salud Santa Ana | Salta | Argentina |
| ID | Term |
|---|---|
| D006973 | Hypertension |
| ID | Term |
|---|---|
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
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| ID | Term |
|---|---|
| D015190 | Blood Glucose Self-Monitoring |
| ID | Term |
|---|---|
| D001774 | Blood Chemical Analysis |
| D019963 | Clinical Chemistry Tests |
| D019411 | Clinical Laboratory Techniques |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
| D003940 | Diagnostic Techniques, Endocrine |
| D008991 | Monitoring, Physiologic |
| D000085263 | Self-Testing |
| D012648 | Self Care |
| D013812 | Therapeutics |
| D008919 | Investigative Techniques |
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