Rationale and design of a cluster randomized trial of a multi-faceted intervention in people with hypertension: The Heart Outcomes Prevention and Evaluation 4 (HOPE-4) Study

Publication date: Available online 22 June 2018 Source:American Heart Journal Author(s): Jon-David Reid Schwalm, Tara McCready, Pablo Lamelas, Hadi Musa, Patricio Lopez-Jaramillo, Khalid Yusoff, Martin McKee, Paul Anthony Camacho, Jose Lopez-Lopez, Fadhlina Majid, Lehana Thabane, Shofique Islam, Salim Yusuf 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 non-physician health workers (NPHW) 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 (1376 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 NPHW in the community, who...
Source: American Heart Journal - Category: Cardiology Source Type: research