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dc.contributor.authorPraveen, D
dc.contributor.authorPatel, A
dc.contributor.authorMacMahon, S
dc.contributor.authorPrabhakaran, D
dc.contributor.authorClifford, GD
dc.contributor.authorMaulik, PK
dc.contributor.authorJoshi, R
dc.contributor.authorJan, S
dc.contributor.authorHeritier, S
dc.contributor.authorPeiris, D
dc.date.accessioned2019-12-11T23:49:47Z
dc.date.available2019-12-11T23:49:47Z
dc.date.issued2013-11-25
dc.identifier.citationPraveen, D., Patel, A., McMahon, S. et al. A multifaceted strategy using mobile technology to assist rural primary healthcare doctors and frontline health workers in cardiovascular disease risk management: protocol for the SMARTHealth India cluster randomised controlled trial. Implementation Sci 8, 137 (2013) doi:10.1186/1748-5908-8-137en_AU
dc.identifier.urihttps://hdl.handle.net/2123/21509
dc.description.abstractBackground: Blood Pressure related disease affected 118 million people in India in the year 2000; this figure will double by 2025. Around one in four adults in rural India have hypertension, and of those, only a minority are accessing appropriate care. Health systems in India face substantial challenges to meet these gaps in care, and innovative solutions are needed. Methods: We hypothesise that a multifaceted intervention involving capacity strengthening of primary healthcare doctors and non-physician healthcare workers through use of a mobile device-based clinical decision support system will result in improved blood pressure control for individuals at high risk of a cardiovascular disease event when compared with usual healthcare. This intervention will be implemented as a stepped wedge, cluster randomised controlled trial in 18 primary health centres and 54 villages in rural Andhra Pradesh involving adults aged ≥40 years at high cardiovascular disease event risk (approximately 15,000 people). Cardiovascular disease event risk will be calculated based on World Health Organisation/International Society of Hypertension’s region-specific risk charts. Cluster randomisation will occur at the level of the primary health centres. Outcome analyses will be conducted blinded to intervention allocation. Expected outcomes: The primary study outcome is the difference in the proportion of people meeting guideline-recommended blood pressure targets in the intervention period vs. the control period. Secondary outcomes include mean reduction in blood pressure levels; change in other cardiovascular disease risk factors, including body mass index, current smoking, reported healthy eating habits, and reported physical activity levels; self-reported use of blood pressure and other cardiovascular medicines; quality of life (using the EQ-5D); and cardiovascular disease events (using hospitalisation data). Trial outcomes will be accompanied by detailed process and economic evaluations. Significance: The findings are likely to inform policy on a scalable strategy to overcome entrenched inequities in access to effective healthcare for under-served populations in low and middle income country settings. Trial registration: Clinical Trial Registry India CTRI/2013/06/003753.en_AU
dc.language.isoen_AUen_AU
dc.publisherBMCen_AU
dc.relationNHMRC GNT057128, NHMRC GNT1040147en_AU
dc.titleA multifaceted strategy using mobile technology to assist rural primary healthcare doctors and frontline health workers in cardiovascular disease risk management: protocol for the SMARTHealth India cluster randomised controlled trialen_AU
dc.typeArticleen_AU
dc.identifier.doi10.1186/1748-5908-8-137
dc.type.pubtypePublisher versionen_AU


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