As undiagnosed and untreated hypertension is one of the largest drivers of cardiovascular disease in sub-Saharan Africa approaches are needed to optimize the hypertension care cascade. The HIV treatment platform in low and middle income countries provides a robust, scalable foundation to address other chronic care priorities, such as hypertension. This proposal will evaluate an evidence-based intervention designed to improve chronic care services (the Systems Analysis and Improvement Approach (SAIA)) for hypertension detection and management in people living with HIV, and will build evidence on how to achieve rapid, sustainable and scalable improvements in services that can dramatically improve population health in resource-limited countries.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
305
The Systems Analysis and Improvement Approach to Optimize the Hypertension Care Cascade for People Living with HIV (SAIA-HTN) is a five-step systems analysis and iterative improvement cycle intervention which will be implemented by study nurses and district managers in intervention facilities. Components of the intervention include joint care cascade analysis, patient flow mapping and continuous quality improvement, aimed to incrementally improve hypertension screening, diagnosis, treatment and care in the HIV+ population at intervention health facilities.
Hospital Distrital de Catandica
Catandica, Manica Province, Mozambique
Centro de Saude 1 de Maio
Chimoio, Manica Province, Mozambique
Centro de Saude 7 de Abril
Chimoio, Manica Province, Mozambique
Centro de Saude Eduardo Mondlane
Chimoio, Manica Province, Mozambique
Centro de Saude Nhamaonha
Chimoio, Manica Province, Mozambique
Centro de Saude de Sussundenga
Sussundenga, Manica Province, Mozambique
Centro de Saude Vanduzi
Vanduzi, Manica Province, Mozambique
Centro de Saude de Macurungo
Beira, Sofala, Mozambique
Centro de Saude de Manga Mascarenhas
Beira, Sofala, Mozambique
Centro de Saude de Manga Nhanconjo
Beira, Sofala, Mozambique
...and 6 more locations
Controlled Hypertension
The proportion of HIV-infected patients with controlled hypertension among those who were diagnosed with hypertension and picked up their medications after receiving a prescription
Time frame: Per Phase: up 3 months for Baseline Phase, up to 2 years for Intensive Implementation Phase, up to 1 year for Sustainment Phase.
Blood Pressure Screening
The proportion of HIV-infected patients who were screened for hypertension
Time frame: Per Phase: up 3 months for Baseline Phase, up to 2 years for Intensive Implementation Phase, up to 1 year for Sustainment Phase.
Hypertension Diagnosis
The proportion of HIV-infected patients diagnosed with hypertension among those who were screened
Time frame: Per Phase: up 3 months for Baseline Phase, up to 2 years for Intensive Implementation Phase, up to 1 year for Sustainment Phase.
Hypertension Treatment Prescription
The proportion of hypertension medication-eligible HIV patients receiving a prescription
Time frame: Per Phase: up 3 months for Baseline Phase, up to 2 years for Intensive Implementation Phase, up to 1 year for Sustainment Phase.
Hypertension Medication Pick up
The proportion of HIV patients who are hypertension medication-eligible and pick up their medications after receiving a prescription
Time frame: Per Phase: up 3 months for Baseline Phase, up to 2 years for Intensive Implementation Phase, up to 1 year for Sustainment Phase.
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