Trial reportPloS one2017
Implementation of a comprehensive intervention for patients at high risk of cardiovascular disease in rural China: A pragmatic cluster randomized controlled trial.
Trial report in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 4 of them syntheses that pooled it.
What it found
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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
15 citing papers in PubMed, 4 syntheses or guidelines pooled it, 30 citations in OpenAlex.
- Interventions to improve adherence to clinical practice guidelines when treating cardiovascular disease: a systematic review.Irish journal of medical science · 2025Pooled it
- Quality improvement strategies for diabetes care: Effects on outcomes for adults living with diabetes.The Cochrane database of systematic reviews · 2023Pooled it
- Cardiovascular disease risk prediction models in the Chinese population- a systematic review and meta-analysis.BMC public health · 2022Pooled it
- Implementation research on noncommunicable disease prevention and control interventions in low- and middle-income countries: A systematic review.PLoS medicine · 2022Pooled it
- Trial
- Process Evaluation of a Clustered Randomized Control Trial of a Comprehensive Intervention to Reduce the Risk of Cardiovascular Events in Primary Health Care in Rural China.International journal of environmental research and public health · 2020Trial
- Cardiovascular risk reduction with integrated care: results of 8 years follow up.BMC primary care · 2023Article
- Article
- Predictive Value of the Age, Creatinine, and Ejection Fraction (ACEF) Score in Cardiovascular Disease among Middle-Aged Population.Journal of clinical medicine · 2022Article
- mHealth guideline training for non-communicable diseases in primary care facilities in Nigeria: a mixed methods pilot study.BMJ open · 2022Article
- Adapting and implementing training, guidelines and treatment cards to improve primary care-based hypertension and diabetes management in a fragile context: results of a feasibility study in Sierra Leone.BMC public health · 2020Article
- Decentralising NCD management in rural southern Africa: evaluation of a pilot implementation study.BMC public health · 2020Article
- The Impact of Treatment Adherence for Patients With Diabetes and Hypertension on Cardiovascular Disease Risk: Protocol for a Retrospective Cohort Study, 2008-2018.JMIR research protocols · 2019Article
- Comparing the income-related inequity of tested prevalence and self-reported prevalence of hypertension in China.International journal for equity in health · 2018Article
- Real world evidence: experience and lessons from China.BMJ (Clinical research ed.) · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 5 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThis study aims to assess whether a standard intervention package of cardiovascular disease (CVD) care was being delivered effectively, and if it was associated with improved lifestyle and biomedical indicators.
methodsIn rural China, we implemented a pragmatic cluster randomized controlled trial for 12 months, randomized at the township hospital level, and compared with usual care. Intervention case management guideline, training and performance monitoring meeting and patient support activities were designed to fit within the job description of family doctors in the township hospitals and comprised: 1) prescription of a standardised package of medicines targeted at those with hypertension or diabetes; 2) advice about specific lifestyle interventions; and 3) advice about medication adherence. Participants were 50-74 years old, had hypertension and CVD risk scores >20% or diabetes, but were excluded if a history of severe CVD events. We also randomly selected 100 participants from six selected clusters per arm as a panel to collect intermediate biomedical indicators over time.
resultsA total of 28,130 participants, in 33 intervention and 34 control township hospitals, were recruited. Compared with the control arm, participants in the intervention arm had substantially improved prescribing rates of anti-hypertensives, statins and aspirin (P<0.001), and had higher medication taking rates of aspirin and statins (P<0.001). Mean systolic and diastolic blood pressures were similar across both arms (0.15 mmHg, P = 0.79, and 0.52 mmHg, P = 0.05, respectively). In the panel, (950) rates of smoking (OR = 0.23, P = 0.02) and salt intake (OR = 2.85, P = 0.03) were significantly reduced in the intervention versus control arms, but there were no statistically significant improvement over the 12 month follow-up period in biomedical indicators (P>0.05).
conclusionImplementation of the package by family doctors was feasible and improved prescribing and some lifestyle changes. Additional measures such as reducing medication costs and patient education are required.
trial registrationCurrent Controlled Trials ISRCTN58988083.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.