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Rationale and design of leveraging the HIV platform for hypertension control in Africa: protocol of a cluster-randomised controlled trial in Uganda

INTRODUCTION: There is a high burden of hypertension (HTN) among HIV-infected people in Uganda. However, capacity to prevent, diagnose and treat HTN is suboptimal. This study seeks to leverage the existing HIV-related infrastructure in primary care health facilities (HFs) using the integrated HIV/HT...

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Autores principales: Atukunda, Mucunguzi, Kabami, Jane, Mutungi, Gerald, Twinamatsiko, Brian, Nangendo, Joan, Shade, Starley B, Charlebois, Edwin, Grosskurth, Heiner, Kamya, Moses, Okello, Emmy
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9743290/
https://www.ncbi.nlm.nih.gov/pubmed/36600388
http://dx.doi.org/10.1136/bmjopen-2022-063227
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author Atukunda, Mucunguzi
Kabami, Jane
Mutungi, Gerald
Twinamatsiko, Brian
Nangendo, Joan
Shade, Starley B
Charlebois, Edwin
Grosskurth, Heiner
Kamya, Moses
Okello, Emmy
author_facet Atukunda, Mucunguzi
Kabami, Jane
Mutungi, Gerald
Twinamatsiko, Brian
Nangendo, Joan
Shade, Starley B
Charlebois, Edwin
Grosskurth, Heiner
Kamya, Moses
Okello, Emmy
author_sort Atukunda, Mucunguzi
collection PubMed
description INTRODUCTION: There is a high burden of hypertension (HTN) among HIV-infected people in Uganda. However, capacity to prevent, diagnose and treat HTN is suboptimal. This study seeks to leverage the existing HIV-related infrastructure in primary care health facilities (HFs) using the integrated HIV/HTN care model to improve health outcomes of patients with HIV and HTN. METHODS AND ANALYSIS: Integrated HIV/HTN study a type-1 effectiveness/implementation cluster randomised trial, will evaluate the effectiveness of a multicomponent model intervention in 13 districts randomised to the intervention arm compared with 13 districts randomised to control. Two randomly selected HFs per district and their patients will be eligible to participate. The intervention will comprise training of primary healthcare (PHC) providers followed by regular supervision, integration of HTN care into HIV clinics, improvement of the health management information system, IT-based messaging to improve communication among frontline PHCs and district-level managers. HTN care guidelines, sphygmomanometers, patient registers and a buffer stock of essential drugs will be provided to HFs in both study arms. We will perform cross-sectional surveys at baseline, 12 and 24 months, on a random sample of patients attending HFs to measure effectiveness of the integrated care model between 2021 and 2024. We will perform in-depth interviews of providers, patients and healthcare managers to assess barriers and facilitators of integrated care. We will measure the cost of the intervention through microcosting and time-and-motion studies. The outcomes will be analysed taking the clustered structure of the data set into account. ETHICS AND DISSEMINATION: Ethics approval has been obtained from the Research Ethics Committees at London School of Hygiene and Tropical Medicine, and Makerere University School of Medicine. All participants will provide informed consent prior to study inclusion. Strict confidentiality will be applied throughout. Findings will be disseminated to public through meetings, and publications. TRIAL REGISTRATION NUMBER: NCT04624061
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spelling pubmed-97432902022-12-13 Rationale and design of leveraging the HIV platform for hypertension control in Africa: protocol of a cluster-randomised controlled trial in Uganda Atukunda, Mucunguzi Kabami, Jane Mutungi, Gerald Twinamatsiko, Brian Nangendo, Joan Shade, Starley B Charlebois, Edwin Grosskurth, Heiner Kamya, Moses Okello, Emmy BMJ Open Health Services Research INTRODUCTION: There is a high burden of hypertension (HTN) among HIV-infected people in Uganda. However, capacity to prevent, diagnose and treat HTN is suboptimal. This study seeks to leverage the existing HIV-related infrastructure in primary care health facilities (HFs) using the integrated HIV/HTN care model to improve health outcomes of patients with HIV and HTN. METHODS AND ANALYSIS: Integrated HIV/HTN study a type-1 effectiveness/implementation cluster randomised trial, will evaluate the effectiveness of a multicomponent model intervention in 13 districts randomised to the intervention arm compared with 13 districts randomised to control. Two randomly selected HFs per district and their patients will be eligible to participate. The intervention will comprise training of primary healthcare (PHC) providers followed by regular supervision, integration of HTN care into HIV clinics, improvement of the health management information system, IT-based messaging to improve communication among frontline PHCs and district-level managers. HTN care guidelines, sphygmomanometers, patient registers and a buffer stock of essential drugs will be provided to HFs in both study arms. We will perform cross-sectional surveys at baseline, 12 and 24 months, on a random sample of patients attending HFs to measure effectiveness of the integrated care model between 2021 and 2024. We will perform in-depth interviews of providers, patients and healthcare managers to assess barriers and facilitators of integrated care. We will measure the cost of the intervention through microcosting and time-and-motion studies. The outcomes will be analysed taking the clustered structure of the data set into account. ETHICS AND DISSEMINATION: Ethics approval has been obtained from the Research Ethics Committees at London School of Hygiene and Tropical Medicine, and Makerere University School of Medicine. All participants will provide informed consent prior to study inclusion. Strict confidentiality will be applied throughout. Findings will be disseminated to public through meetings, and publications. TRIAL REGISTRATION NUMBER: NCT04624061 BMJ Publishing Group 2022-12-08 /pmc/articles/PMC9743290/ /pubmed/36600388 http://dx.doi.org/10.1136/bmjopen-2022-063227 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Health Services Research
Atukunda, Mucunguzi
Kabami, Jane
Mutungi, Gerald
Twinamatsiko, Brian
Nangendo, Joan
Shade, Starley B
Charlebois, Edwin
Grosskurth, Heiner
Kamya, Moses
Okello, Emmy
Rationale and design of leveraging the HIV platform for hypertension control in Africa: protocol of a cluster-randomised controlled trial in Uganda
title Rationale and design of leveraging the HIV platform for hypertension control in Africa: protocol of a cluster-randomised controlled trial in Uganda
title_full Rationale and design of leveraging the HIV platform for hypertension control in Africa: protocol of a cluster-randomised controlled trial in Uganda
title_fullStr Rationale and design of leveraging the HIV platform for hypertension control in Africa: protocol of a cluster-randomised controlled trial in Uganda
title_full_unstemmed Rationale and design of leveraging the HIV platform for hypertension control in Africa: protocol of a cluster-randomised controlled trial in Uganda
title_short Rationale and design of leveraging the HIV platform for hypertension control in Africa: protocol of a cluster-randomised controlled trial in Uganda
title_sort rationale and design of leveraging the hiv platform for hypertension control in africa: protocol of a cluster-randomised controlled trial in uganda
topic Health Services Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9743290/
https://www.ncbi.nlm.nih.gov/pubmed/36600388
http://dx.doi.org/10.1136/bmjopen-2022-063227
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