Interventions to Improve Non-communicable Disease Management During the Pandemic

University of Toronto1,500 enrolled

Overview

This randomized controlled trial aims to implement and evaluate a comprehensive package of digital health interventions for integrated COVID-non-communicable diseases (NCDs) care to manage NCDs in primary care facilities in rural Pakistan. The main questions it aims to answer are 1) whether such interventions are effective; 2) how they were implemented; and 3) whether such interventions are cost-effective. 30 rural health centers in Punjab Province, Pakistan will be randomized into two groups. The intervention group will provide a comprehensive package of digital health interventions to connect patients, patient champions, and public health providers to improve the management of NCDs during the pandemic, including 1) providing training to health providers regarding an integrated NCD-COVID guideline; 2) using a smartphone app to improve NCD case management and linking with patient champions; and 3) employing telementoring platform to improve quality of care. Usual care will be provided in the control group. Researchers will compare the two groups to see if the systolic blood pressure can be controlled better in the intervention group at 10 months.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

SINGLE

Enrollment

1,500

Conditions

Noncommunicable Diseases COVID-19

Eligibility

Sex: ALLMin age: 25 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Reside in the catchment of selected rural health centers; * Provide informed consent; * Newly diagnosed of hypertension, i.e., having a baseline blood pressure reading (recorded from the second blood pressure reading using a validated electronic blood pressure machine) of more than 140/90 mmHg; or who is an existing hypertensive patient but with uncontrolled blood pressure with a baseline blood pressure over 140/90 mmHg; * Have a smartphone or can access a smartphone from a relative. Exclusion Criteria: * Patients having an acute cardiovascular event in the last three months, terminal disease, or other conditions that the rural health center staff determine that will make participation impossible.

Outcomes

Primary Outcomes

Systolic blood pressure (mmHg) measured in the rural health center

Time frame: At 10 months

Secondary Outcomes

Diastolic blood pressure (mmHg) measured in the rural health center

Time frame: At 10 months

Percentage of patients with controlled blood pressure measured below 140/90 mmHg for patients with hypertension but without diabetes, and below 130/80 mmHg for patients with diabetes

Time frame: At 10 months

Random blood glucose (mmol/L)

Time frame: At 10 months

Body mass index (BMI)

Time frame: At 10 months

Number of consultations with RHC doctors, including both in-person and virtual consultations

Time frame: During the 10-month intervention period

Systolic and diastolic blood pressure

Time frame: At 6 months

Proportion of patients who have had at least three doses of COVID vaccinations

Time frame: At 10 months

Proportion of participants been admitted to district hospitals for any reasons

Time frame: During the 10-month intervention period

All-cause mortality rate

Time frame: During the 10-month intervention period

Interventions to Improve Non-communicable Disease Management During the Pandemic

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes

Central Contacts