ArticleBJGP open2019
Enhanced hypertension care through private clinics in Pakistan: a cluster randomised trial.
Article in BJGP open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 3 of them syntheses that pooled it.
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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.
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Who cites it
13 citing papers in PubMed, 3 syntheses or guidelines pooled it, 15 citations in OpenAlex.
- Implementation research on noncommunicable disease prevention and control interventions in low- and middle-income countries: A systematic review.PLoS medicine · 2022Pooled it
- Pooled it
- Interventions for improving medication-taking ability and adherence in older adults prescribed multiple medications.The Cochrane database of systematic reviews · 2020Pooled it
- Integration of Cardiovascular Disease Services within Primary Health Care Systems: Insights from South Asia.Current atherosclerosis reports · 2026Review
- Medication adherence interventions for South Asian populations with cardiovascular disease: A systematic review and narrative synthesis.PLOS global public health · 2026Article
- Co-Producing an Intervention to Reduce Inappropriate Antibiotic Prescribing Among Dental Practitioners in India.Antibiotics (Basel, Switzerland) · 2025Article
- Evaluating the long-term cost-effectiveness of the COBRA-BPS programme in Pakistan.BMJ public health · 2025Article
- Challenges of managing hypertension in Pakistan - a review.Clinical hypertension · 2023Review
- Article
- 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
- Delivering integrated hypertension care at private health facilities in urban Pakistan: a process evaluation.BJGP open · 2018Article
Corrections and comments
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Authors and funding
11 authors at 7 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHypertension in Pakistan affects 33% of people aged ≥45 years, and in urban areas around 70% of basic health care occurs in private facilities.
aimTo assess whether enhanced care at urban private clinics resulted in better control of hypertension, cardiovascular disease (CVD) risk factors, and treatment adherence. DESIGN &
settingA two-arm cluster randomised controlled trial was conducted at 26 private clinics (in three districts of Punjab) between January 2015-September 2016. Both arms had enhanced screening and diagnosis of hypertension and related conditions, and patient recording processes. Intervention facilities also had a clinical care guide, additional drugs for hypertension, a patient lifestyle education flipchart, associated training, and mobile phone follow-up.
methodClinics were randomised in a 1:1 ratio (sealed envelope lottery method). A total of 574 intervention and 564 control patients in 13 clusters in each arm were recruited (male and female, aged ≥25 years, systolic blood pressure [SBP] >140 mmHg, and/or diastolic blood pressure [DBP] >90 mmHg). The primary outcome was change in SBP from baseline to 9-month follow-up.Staff and patients were not blinded, but outcome assessors were blinded.
resultsNine-month primary outcomes were available for 522/574 (90.9%) intervention and 484/564 (85.8%) control participants (all clusters). The unadjusted cluster-level analysis results were as follows: mean intervention outcome was -25.2 mmHg (95% confidence intervals [CI] = -29.9 to-20.6); mean control outcome was -9.4 mmHg (95% CI = 21.2 to 2.2); and mean control-intervention difference was 15.8 (95% CI = 3.6 to 28.0;
conclusionThe findings and separate process evaluation support the scaling of an integrated CVD-hypertension care intervention in urban private clinics in areas lacking public primary care in Pakistan.
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