在秘鲁普诺通过社区参与系统 (ANDES) 解决高血压和糖尿病问题:混合型2有效性和实施随机对照试验的理由和研究协议
Lindsay J Underhill1, Kendra N Williams2,3, Lucy Cordova-Ascona4
1Global Health Center, Institute for Public Health and Cardiovascular Division, Department of Medicine, Washington University in St. Louis, St. Louis, MO, USA.
这项研究评估了社区卫生工作者 (CHW) 领导的计划,以改善秘鲁的高血压控制. 安德斯试验将评估其有效性和实施,潜在地减少低资源环境中的心血管疾病.
科学领域:
- 公共卫生 公共卫生
- 心血管疾病研究研究
- 卫生系统 实施 科学 科学
背景情况:
- 高血压是秘鲁普遍存在的心血管疾病,尽管有治疗方法,但控制能力不足.
- 一个混合型2随机对照试验旨在解决国家初级保健系统中的这一差距.
- 安德斯研究 (NCT05524987) 侧重于秘鲁普诺,将社区卫生工作者 (CHW) 纳入高血压管理.
研究的目的:
- 测试CHW领导的高血压控制计划的实施和有效性.
- 评估该计划对血压,药物坚持和生活方式因素的影响.
- 提供对影响高血压管理策略在LMICs成功实施和扩展的因素的见解.
主要方法:
- 在秘鲁普诺招募了1068名患有高血压的成年参与者.
- 个体随机化 (1:1) 给通常的护理或为期12个月的CHW主导的家庭干预.
- 干预包括血压监测,药物支持和生活方式咨询,以CFIR和RE-AIM框架为指导.
主要成果:
- 主要结局:静缩血压的平均变化.
- 二次临床结局:透静血压和HbA1C.
- 实施结果:将评估忠实性,覆盖范围,采用,可持续性,可接受性和成本效益.
结论:
- 安德斯试验是秘鲁首个由CHW领导的高血压和2型糖尿病管理策略.
- 结果将为秘鲁和其他LMICs的ANDES战略的调整和扩展提供信息.
- 该研究支持综合护理方法,可能降低发病率和死亡率.
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