Please use this identifier to cite or link to this item:
Title: Rationale and design of a cluster randomized trial of a multifaceted intervention in people with hypertension: The Heart Outcomes Prevention and Evaluation 4 (HOPE-4) Study
Authors: Schwalm, Jon-David Reid
McCready, Tara
Lamelas, Pablo
Musa, Hadi
Lopez-Jaramillo, Patricio
Yusoff, Khalid
McKee, Martin
Camacho, Paul Anthony
Lopez-Lopez, Jose
Majid, Fadhlina
Thabane, Lehana
Islam, Shofiqul
Yusuf, Salim
Population Health Research Institute, Hamilton, Ontario, Canada
Department of Medicine, Division of Cardiology, McMaster University, Hamilton, Ontario, Canada
Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
Research Institute, Fundación Oftalmológica de Santander, Floridablanca, Colombia
Masira Institute, Medical School, Universidad de Santander, Bucaramanga, Colombia
Faculty of Medicine, Universiti Teknologi Majlis Amanah Rakyat, Kuala Lumpur, Malaysia
Faculty of Medicine and Health Sciences, UCSI University, Kuala Lumpur, Malaysia
Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
Medical School, Universidad Autonoma de Bucaramanga, Bucaramanga, Colombia
Universiti Teknologi MARA, Kuala Lumpur, Malaysia
Issue Date: Jul-2018
Publisher: American Heart Journal , 2018.
Abstract: Background Cardiovascular disease is the leading cause of death throughout the world, with the majority of deaths occurring in low- and middle-income countries. Despite clear evidence for the benefits of blood pressure reduction and availability of safe and low-cost medications, most individuals are either unaware of their condition or not adequately treated. Objective The primary objective of this study is to evaluate whether a community-based, multifaceted intervention package primarily provided by nonphysician health workers can improve long-term cardiovascular risk in people with hypertension by addressing identified barriers at the patient, health care provider, and health system levels. Methods/design HOPE-4 is a community-based, parallel-group, cluster randomized controlled trial involving 30 communities (1,376 participants) in Colombia and Malaysia. Participants ≥50 years old and with newly diagnosed or poorly controlled hypertension were included. Communities were randomized to usual care or to a multifaceted intervention package that entails (1) detection, treatment, and control of cardiovascular risk factors by nonphysician health workers in the community, who use tablet-based simplified management algorithms, decision support, and counseling programs; (2) free dispensation of combination antihypertensive and cholesterol-lowering medications, supervised by local physicians; and (3) support from a participant-nominated treatment supporter (either a friend or family member). The primary outcome is the change in Framingham Risk Score after 12 months between the intervention and control communities. Secondary outcomes including change in blood pressure, lipid levels, and Interheart Risk Score will be evaluated. Significance If successful, the study could serve as a model to develop low-cost, effective, and scalable strategies to reduce cardiovascular risk in people with hypertension.
Description: 10 p. Electronico
ISBN: 0002-8703
Appears in Collections:AIA. Artículos Indexados

Files in This Item:
File Description SizeFormat 
Rationale and design of a cluster randomized trial..PNGImagen79.26 kBimage/pngThumbnail

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.