New model developed by researchers from PHFI, AIIMS and Peking University could mean better primary care in resource-limited areas
In a first dual-country trail, researchers from India and China have together discovered cost-effective ways to improve the quality of primary care and clinical outcomes in resource-limited settings through smart mobile application which could have major benefits for the general population who suffer known cardiovascular diseases. The study result was recently published in Circulation with an invited editorial.
The simplified cardiovascular management programme, also known as the SimCard study, was a one-year cluster-randomised controlled trial carried out in 47 villages in Haryana, India and Tibet, China and with limited access to basic cardiovascular disease (CVD) management and appropriate medications. The study was carried out by the Public Health Foundation of India (PHFI) in collaboration with the All India Institute of Medical Sciences (AIIMS) in India and The George Institute for Global Health at Peking University Health Science Center in collaboration with Tibet University in China.
The study enrolled 2086 individuals with high CVD risks, defined as over 40 years old with a self-reported history of CVD and a measured systolic blood pressure over 160mmHg. Community health workers (CHWs) were deployed and trained to manage those individuals with the assistance of an Android smartphone app consisting of a guideline-based but simplified CVD management programme.
A simplified ‘2+2’ intervention model, which consisted of two medications (blood pressure lowering agents and aspirin) and two lifestyle modifications (smoking cessation and salt reduction), was developed. The model was based on the international and national clinical guidelines for CVD management so that it can be easily implemented and incorporated into the existing local healthcare system as well. In both China and India, interventions were tailored to the local cultures and customs when possible. For example, health educational materials on lifestyle in China and India were all provided in local languages with cultural-specific images.
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