In the 'Hope 4" trial, care was led by non-physician health workers using a computer tablet to help decision-making and working closely with physicians. Non-physician led care was supported by counselling to improve health behaviours in people with high blood pressure, two or more free blood pressure-lowering drugs, a statin, and help from family and friends as treatment supporters. This comprehensive approach reduced participants' blood pressure and risk of a future heart attack or stroke by more than double the amount compared to those who received treatment only from physicians.
Hypertension is the leading cause of cardiovascular disease globally but its control in the community is not adequately managed worldwide -- in both poor and rich countries.
Governments - World - Goal - Mortality - %
"Governments around the world have agreed on an ambitious goal to reduce cardiovascular mortality by 30% by 2030. But we will only achieve this goal if we can find novel ways to remove all barriers to cardiovascular risk reduction, such as access to care, compliance with taking medications, and adoption of healthy behaviours." says Dr Jon-David Schwalm, McMaster University, Canada, who led the research.
The new trial included 1,371 adults aged 50 or older from 30 urban and rural communities across Colombia and Malaysia. Participants had uncontrolled high blood pressure and a raised risk of cardiovascular disease. A pre-trial appraisal identified barriers to following through with medical treatment, including the time and expense of travelling to attend physician visits, lost wages, and costs of drugs.
Intervention - Group - Communities - Health - Workers
For the intervention group, which included 14 communities, non-physician health workers led the screening, detection, treatment and control of cardiovascular risk factors. Health workers were able to respond to participants' needs, for example by visiting them at home, providing counselling to improve lifestyles and delivering medications. Prescription recommendations were checked by local physicians, who agreed with health workers' assessments 93% of...
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