Control of Blood Pressure and Risk Attenuation-rural Bangladesh, Pakistan, Sri Lanka, Feasibility Study

Summary

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.

Conditions

• Hypertension

Interventions

OTHER

Multicomponent intervention

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

Sponsors & Collaborators

• International Centre for Diarrhoeal Disease Research, Bangladesh

  collaborator OTHER

• Aga Khan University

  collaborator OTHER

• University of Kelaniya

  collaborator OTHER

• Duke-NUS Graduate Medical School

  lead OTHER

Principal Investigators

• Tazeen H Jafar, MD, MPH · Duke-NUS, Singapore

• Aliya Naheed · Initiative for Non-Communicable Diseases icddr,b, Bangladesh

• Imtiaz Jehan · Aga Khan University

• Asita de Silva · University of Kelaniya, Sri Lanka

• Shah Ebrahim · London School of Hygiene and Tropical Medicine

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

40 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2014-08-31

Primary Completion

2015-05-31

Completion

2015-05-31

Countries

• Bangladesh
• Pakistan
• Sri Lanka

Study Locations