Evaluating a multicomponent program to improve hypertension control in Guatemala: study protocol for an effectiveness-implementation cluster randomized trial.

Trials
Alejandra Paniagua-AvilaVilma Irazola

Abstract

Hypertension is a major risk factor for cardiovascular disease (CVD). Despite advances in hypertension prevention and treatment, the proportion of patients who are aware, treated and controlled is low, particularly in low-income and middle-income countries (LMICs). We will evaluate an adapted version of a multilevel and multicomponent hypertension control program in Guatemala, previously proven effective and feasible in Argentina. The program components are: protocol-based hypertension treatment using a standardized algorithm; team-based collaborative care; health provider education; health coaching sessions; home blood pressure monitoring; blood pressure audit; and feedback. Using a hybrid type 2 effectiveness-implementation design, we will evaluate clinical and implementation outcomes of the multicomponent program in Guatemala over an 18-month period. Through a cluster randomized trial, we will randomly assign 18 health districts to the intervention arm and 18 to enhanced usual care across five departments, enrolling 44 participants per health district and 1584 participants in total. The clinical outcomes are (1) the difference in the proportion of patients with controlled hypertension (< 130/80 mmHg) between the intervention...Continue Reading

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References

Sep 4, 1999·American Journal of Public Health·R E GlasgowS M Boles
May 16, 2003·JAMA : the Journal of the American Medical Association·Aram V ChobanianUNKNOWN National High Blood Pressure Education Program Coordinating Committee
Mar 3, 2007·American Journal of Public Health·Emily D ParkerPamela J Schreiner
Mar 7, 2007·Circulation·Fernando LanasUNKNOWN INTERHEART Investigators in Latin America
Mar 26, 2008·Archives of Internal Medicine·Karl HorvathAndrea Siebenhofer
Oct 20, 2010·Administration and Policy in Mental Health·Enola ProctorMelissa Hensley
Feb 8, 2011·Lancet·Goodarz DanaeiUNKNOWN Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group (Blood Pressure)
Mar 17, 2015·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Scott D RamseySean D Sullivan
Mar 10, 2017·JAMA : the Journal of the American Medical Association·Dori SteinbergLaura Svetkey
Dec 7, 2018·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Federico AugustovskiAndrés Pichon Riviere
Apr 16, 2019·Frontiers in Public Health·Russell E GlasgowPaul A Estabrooks

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