Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
Department of Medicine and Therapeutics, College of Health Sciences, University of Ghana Medical School, Accra, Ghana.
BMJ Open. 2024 Nov 4;14(11):e082954. doi: 10.1136/bmjopen-2023-082954.
Over the past few decades, the prevalence of hypertension in Ghana has increased significantly. Insufficient diagnosis and suboptimal management of diagnosed cases result in increased mortality and morbidity due to poor blood pressure control and attendant complications. This highlights the need for new models of hypertension control in highly burdened, urban poor communities. This study aims to identify patients with hypertension in the coastal communities of the Greater Accra region, link patients newly diagnosed with hypertension to appropriate medical care and monitor treatment outcomes using task-shifting strategies.
In this quasi-experimental study, participants with a mean blood pressure of ≥140/90 mm Hg will be recruited from seven coastal communities of Ghana's Greater Accra region. Based on proportion to the size of these communities, we will screen and recruit 10 000 and 3000 participants, respectively, from all study sites. We will link the recruited individuals to designated health facilities and follow them for a year to assess treatment outcomes, blood pressure control, adherence to treatment, anthropometric measurements, funduscopic assessment, urinalysis, blood urea nitrogen and creatinine level, ECG and echocardiograms. In addition, we will use mobile health technology to support community screening, blood pressure checks and remote monitoring of patients diagnosed with hypertension, as well as send messages on medication adherence and lifestyle changes. Furthermore, we will conduct focus group discussions among community members and indepth interviews with persons considered to be newly diagnosed with hypertension, community health workers and religious leaders/representatives to assess the knowledge and perceptions of different study participants regarding hypertension diagnosis, management, control, experiences and treatment.
The study was approved by the Ghana Health Service Ethics Review Committee (protocol identification number GHS-ERC 028/08/22). We will obtain written informed consent from each participant. In addition to journal publication, dissemination activities will include a report to the Ghana Health Service on the outcome of the project.
ISRCTN76503336.
在过去的几十年中，加纳的高血压患病率显著增加。由于诊断不足和确诊病例的管理不善，导致血压控制不佳和随之而来的并发症，死亡率和发病率上升。这凸显了在负担沉重的城市贫困社区中需要新的高血压控制模式。本研究旨在确定加纳大阿克拉地区沿海社区的高血压患者，将新诊断出的高血压患者与适当的医疗保健联系起来，并使用任务转移策略监测治疗结果。
在这项准实验研究中，将从加纳大阿克拉地区的七个沿海社区招募平均血压≥140/90mmHg 的参与者。根据这些社区的规模比例，我们将分别从所有研究地点招募 10000 人和 3000 人。我们将把招募到的人联系到指定的医疗机构，并对他们进行为期一年的随访，以评估治疗结果、血压控制、治疗依从性、人体测量指标、眼底检查、尿液分析、血尿素氮和肌酐水平、心电图和超声心动图。此外，我们将使用移动医疗技术支持社区筛查、血压检查和远程监测新诊断出的高血压患者，并发送有关药物依从性和生活方式改变的信息。此外，我们将在社区成员中进行焦点小组讨论，并对被认为新诊断出高血压的人、社区卫生工作者和宗教领袖/代表进行深入访谈，以评估不同研究参与者对高血压诊断、管理、控制、经验和治疗的知识和看法。
该研究已获得加纳卫生局伦理审查委员会的批准（方案识别号 GHS-ERC 028/08/22）。我们将从每位参与者那里获得书面知情同意。除了期刊发表外，传播活动还将包括向加纳卫生局报告项目的结果。
ISRCTN76503336。
