- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02186067
Developing an Integrated System Approach for the Management of Hypertension: A Pilot Study
Hypertension has become a public health concern worldwide due to its significant contribution to the global health burden and its role as a prominent risk factor for the development of a number of chronic diseases such as Cardiovascular diseases (CVD), the leading cause of mortality in Pakistan and Worldwide. According to WHO, about 7.5 million deaths worldwide is attributable to hypertension i.e. about 12.8% of the total of all deaths. This accounts for 57 million disability adjusted life years (DALYS) or 3.7% of total DALYS.
Studies suggest that hypertension is among the top five most common presenting complaints to private general practice clinics. Therefore, primary care physicians/Family physicians are the first line service providers and; thus it is important to manage hypertensive patients early, through lifestyle and treatment interventions that may prevent the complications such as development of CVDs etc.
Study Overview
Detailed Description
To the best of authors' knowledge limited evidence is available from Pakistan on management of hypertension through an integrated approach. Therefore, the aim of the trial is to develop a health delivery system that effectively manages hypertension at primary care level.
Hypothesis: The development of an integrated management approach will be effective in managing hypertension at all levels among hypertensive patients.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Sindh
-
Karachi, Sindh, Pakistan
- The Integrated Medical Services Clinics (IMS)
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Individuals aged 40 years or over visiting the selected IMS centre with known hypertension or with consistently elevated BP on two separate visits (mean of last two of three measurements of systolic pressure ≥140 mm Hg or mean diastolic pressure ≥90 mm Hg) or already receiving treatment will be eligible for inclusion in the study.
Exclusion Criteria:
- Those patients who require intensive care unit or coronary care unit admissions, or are diagnosed to have cognitive impairment, are agitated due to severe pain, non-resident of Karachi, or having language barrier will be excluded from the study.
- A screening form will be designed for the collection of the above mentioned information. The rationale of excluding all the participants with above mentioned condition is that the participants having these health concerns will either not be able to respond to our questionnaire or their presence may confound our results.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Referral System
Referral System: Primary Level Secondary Level Tertiary Level |
Primary Level: Refer patients to secondary care centre if Patients has complicated hypertension (Patients with target organ damage, CVD, CKD or more the 3 drugs) Secondary Level: Community health center at Aga Khan University will serve as the secondary care center. Family physician will manage patients with CVD, CKD or more than 3 drugs. Tertiary care: Cardiologist at the Aga Khan University will manage secondary, resistant and difficult to treat hypertension. Behavioral: Other Interventions CME session by Cardiologist/Consultant Family Physician : At start , and at two months Community screening by Family physicians at the primary care center (open house) once in three months Patient group education session. Once in three months |
No Intervention: Control
Usual/routine care will be provided to the patients
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
At least an absolute 20% point greater proportion of participants in the intervention group achieving blood pressure targets ( SBP <140 mmHg and DBP < 90mmHg)
Time Frame: 6 months
|
6 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Adherence to life style modification
Time Frame: 6 months
|
Adherence to life style modification (exercise, diet, medication) by the patients: This will be assessed through self-report, anthropometric and blood pressure measurement and empty blister count at the follow up visits.
|
6 months
|
Adherence by physicians to hypertension management guidelines
Time Frame: 6 months
|
Adherence by physicians to hypertension management guidelines: assessed through monthly audits conducted by the research medical officer.
|
6 months
|
Cost-Effectiveness
Time Frame: 6 months
|
Cost-Effectiveness: cost of medication (self-report by patient), cost of physician visit (clinic data) etc.
|
6 months
|
Patient Satisfaction
Time Frame: 6 months
|
Patient Satisfaction: This would be assessed through PSQ-18.
|
6 months
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Waris Qidwai, Aga Khan University
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 13102013FM
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Hypertension
-
National Taiwan University Hospital Hsin-Chu BranchRecruitingHypertension,Essential | Hypertension, MaskedTaiwan
-
BayerCompletedPrimary HypertensionChina
-
University of Alabama at BirminghamTroy UniversityCompletedHypertension | Hypertension, Resistant to Conventional Therapy | Uncontrolled Hypertension | Hypertension, White CoatUnited States
-
Columbia UniversityAgency for Healthcare Research and Quality (AHRQ)Active, not recruitingWhite Coat Hypertension | Hypertension,EssentialUnited States
-
Addpharma Inc.Completed
-
Universidade Federal de Santa MariaCompletedHealthy Volunteers | Hypertension, EssentialBrazil
-
Sheffield Teaching Hospitals NHS Foundation TrustUniversity of SheffieldCompletedIdiopathic Pulmonary Arterial Hypertension | Chronic Thromboembolic Pulmonary HypertensionUnited Kingdom
-
China Academy of Chinese Medical SciencesGuang'anmen Hospital of China Academy of Chinese Medical SciencesCompletedHypertension, Resistant to Conventional Therapy | Primary HypertensionChina
-
Cytos Biotechnology AGCompletedMild Essential Hypertension | Moderate Essential HypertensionSwitzerland
Clinical Trials on Referral System
-
Brigham and Women's HospitalThe Commonwealth FundCompletedCommunication | Interprofessional RelationsUnited States
-
US Department of Veterans AffairsCompletedDepression | Cognitive Impairment | IncontinenceUnited States
-
Fondazione IRCCS Istituto Nazionale dei Tumori,...RecruitingAdvanced CancerItaly
-
Geisinger ClinicAmerican Heart Association; Family Health Council of Central Pennsylvania (FHCCP)Not yet recruitingCardiovascular Diseases | Diabetes | Obesity, Maternal
-
University of Dublin, Trinity CollegeRoyal College of Surgeons, Ireland; Irish Cancer Society; National Cancer Control... and other collaboratorsCompleted
-
Centers for Disease Control and PreventionCompletedThe Participant Agreement for Contact Tracing (PACT) Study: Enhancing Partner Notification Services.Contact Tracing | Chlamydia InfectionUnited States
-
University of Massachusetts, WorcesterNational Heart, Lung, and Blood Institute (NHLBI); National Institutes of Health...Enrolling by invitationCardiovascular Diseases | Cancer | Physical InactivityUnited States
-
Lawson Health Research InstituteCanadian Institutes of Health Research (CIHR); AstraZenecaCompletedMyocardial Infarction | Coronary Disease | Unstable AnginaCanada
-
University of California, Los AngelesNational Institute of Mental Health (NIMH); Asociación Civil Impacta Salud...Completed
-
Indiana UniversityIndiana University HealthCompletedChest Pain | Anxiety | MindfulnessUnited States