Trial reportAmerican heart journal2014
Rationale and design of a randomized controlled trial evaluating community health worker-based interventions for the secondary prevention of acute coronary syndromes in India (SPREAD).
Trial report in American heart journal, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Evaluation of a training program of hypertension for accredited social health activists (ASHA) in rural India.BMC health services research · 2018Trial
- Non-physician health workers for improving adherence to medications and healthy lifestyle following acute coronary syndrome: 24-month follow-up study.Indian heart journalTrial
- Trends and differences in cardiovascular disease and alzheimer's disease-related mortality among older adults in the United States, 1999 to 2023: A CDC WONDER database analysis.American heart journal plus : cardiology research and practice · 2025Article
- Article
- Healthcare worker-based opportunistic screening for familial hypercholesterolemia in a low-resource setting.PloS one · 2022Article
- Evaluation of competence training for the minimally trained health worker in type 2 diabetes: A cluster randomized controlled trial.Medicine · 2020Article
- Interventions targeting hypertension and diabetes mellitus at community and primary healthcare level in low- and middle-income countries:a scoping review.BMC public health · 2019Article
- A model for point of care testing for non-communicable disease diagnosis in resource-limited countries.Global health, epidemiology and genomics · 2019Article
- Improving Medication Adherence in Coronary Heart Disease.Current cardiology reports · 2017Review
- Adherence to cardiovascular medications in the South Asian population: A systematic review of current evidence and future directions.World journal of cardiology · 2015Article
- Impact of nurse-led cardiac rehabilitation on patient's behavioral and physiological parameters after a coronary intervention: A pilot randomized controlled trial.Journal of family & community medicineArticle
- Premature coronary artery disease in India: coronary artery disease in the young (CADY) registry.Indian heart journalObservational
- Adherence to pharmacotherapy for secondary prevention of coronary heart disease: A registry-based prospective study.Indian heart journalArticle
Corrections and comments
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Authors and funding
15 authors.
Funding
Abstract
backgroundThere is a need to evaluate and implement cost-effective strategies to improve adherence to treatments in coronary heart disease. There are no studies from low- to middle income countries (LMICs) evaluating trained community health worker (CHW)-based interventions for the secondary prevention of coronary heart disease.
methodsWe designed a hospital-based, open randomized trial of CHW-based interventions versus standard care. Patients after an acute coronary syndrome (ACS) were randomized to an intervention group (a CHW-based intervention package, comprising education tools to enhance self-care and adherence, and regular follow-up by the CHW) or to standard care for 12 months during which study outcomes were recorded. The CHWs were trained over a period of 6 months. The primary outcome measure was medication adherence. The secondary outcomes were differences in adherence to lifestyle modification, physiological parameters (blood pressure [BP], body weight, body mass index [BMI], heart rate, lipids), and major adverse cardiovascular events.
resultsWe recruited 806 patients stabilized after an ACS from 14 hospitals in 13 Indian cities. The mean age was 56.4 (± 11.32) years, and 17.2% were females. A high prevalence of risk factors such as hypertension (43.4%), diabetes (31.9%), tobacco consumption (35.4%), and inadequate physical activity (70.5%) was documented. A little over half had ST-elevation myocardial infarction (53.7%), and 46.3% had non-ST-elevation myocardial infarction or unstable angina.
conclusionThe CHW interventions and training for SPREAD have been developed and adapted for local use. The results and experience of this study will be important to counter the burden of cardiovascular diseases in low- to middle income countries.
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