Community-based HEARTS Intervention (Pilot)

Summary

The goal of this pilot study is to assess the feasibility of health system change intervention with a focus on recruitment of patients with hypertension, initiation of antihypertensive medication, and retention of patients in care at the Community Clinics (CC) with a goal of finalizing the key features of a team- and community-based intervention in rural Bangladesh.

Patients with uncomplicated hypertension will be enrolled, their medical treatment will be provided from CC by a Community Health Care Provider (CHCP) according to the telemedicine-based instruction of Medical Officer from Upazila Health Complex (UHC) with provision of referral to UHC for an in-person evaluation. Participants will be followed up periodically and their medicine will be refilled accordingly.

Conditions

• Hypertension

Interventions

OTHER

Telemedicine-based WHO HEARTS package

Interventions in this study will include- 1. Community- and team-based model of hypertension care delivery 2. Opportunistic hypertension screening at Community Clinic (CC) by Community Health Care Provider (CHCP) 3. Use of a hypertension treatment protocol with amlodipine and losartan and standardized approach to measuring and monitoring BP, retaining participants in care, and promoting adherence 4. Use of Simple App to document BP readings and medications/dosage and to monitor hypertension care delivery at the CC through utilities including dashboards 5. Establishment of telemedicine service between CC and Upazila Health Complex (UHC) 6. Community-based, multi-month prescription refills from CC 7. Training of clinic and research staff on BP measurement following standard techniques 8. Site monitoring and mentorship to ensure screening and patient enrollment/registration 9. Use of text messages to promote follow-up visits and medication adherence

Sponsors & Collaborators

• National Heart Foundation Hospital and Research Institute

  collaborator UNKNOWN

• Johns Hopkins University

  collaborator OTHER

• Non-communicable Disease Control Programme, Directorate General of Health Services, Bangladesh

  collaborator UNKNOWN

• Community Based Health Care, Directorate General of Health Services, Bangladesh

  collaborator UNKNOWN

• National Heart Foundation of Bangladesh

  lead OTHER

Principal Investigators

• Sohel R Choudhury, PhD · National Heart Foundation Hospital and Research Institute

Study Design

Allocation

NA

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Model

SINGLE_GROUP

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2023-08-01

Primary Completion

2025-03-31

Completion

2025-03-31