التفاصيل البيبلوغرافية
| العنوان: |
Enhanced hypertension care through private clinics in Pakistan: a cluster randomised trial. |
| المؤلفون: |
Khan, Muhammad Amir, Khan, Nida, Walley, John D., Khan, Shaheer Ellahi, Hicks, Joseph, Sheikh, Faisal Imtiaz, Khan, Muhammad Ahmar, Ali, Muhammad, Ahmed, Maqsood, Khan, Haroon Jehangir, Zachariah, Rony |
| المصدر: |
BJGP Open; 2019, Vol. 3 Issue 1, p1-11, 11p |
| مصطلحات موضوعية: |
HYPERTENSION, MEDICAL care, TREATMENT effectiveness, RANDOMIZED controlled trials |
| مصطلحات جغرافية: |
PAKISTAN |
| مستخلص: |
Background: Hypertension in Pakistan affects 33% of people aged α45 years, and in urban areas around 70% of basic health care occurs in private facilities. Aim: To assess whether enhanced care at urban private clinics resulted in better control of hypertension, cardiovascular disease (CVD) risk factors, and treatment adherence. Design & setting: A two-arm cluster randomised controlled trial was conducted at 26 private clinics (in three districts of Punjab) between January 2015-September 2016. Both arms had enhanced screening and diagnosis of hypertension and related conditions, and patient recording processes. Intervention facilities also had a clinical care guide, additional drugs for hypertension, a patient lifestyle education flipchart, associated training, and mobile phone follow-up. Method: Clinics were randomised in a 1:1 ratio (sealed envelope lottery method). A total of 574 intervention and 564 control patients in 13 clusters in each arm were recruited (male and female, aged ≥25 years, systolic blood pressure [SBP] >140 mmHg, and/or diastolic blood pressure [DBP] >90 mmHg). The primary outcome was change in SBP from baseline to 9-month follow-up. Staff and patients were not blinded, but outcome assessors were blinded. Results: Nine-month primary outcomes were available for 522/574 (90.9%) intervention and 484/564 (85.8%) control participants (all clusters). The unadjusted cluster-level analysis results were as follows: mean intervention outcome was -25.2 mmHg (95% confidence intervals [CI] = -29.9 to -20.6); mean control outcome was -9.4 mmHg (95% CI = 21.2 to 2.2); and mean control- intervention difference was 15.8 (95% CI = 3.6 to 28.0; P = 0.01). [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
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