Evidence map›Paper›PMID 34013966›Full record

Trial reportAmerican journal of hypertension2021

Effect of a Multicomponent Intervention on Antihypertensive Medication Intensification in Rural South Asia: Post Hoc Analysis of a Cluster RCT.

Liang Feng, Imtiaz Jehan, H Asita de Silva, Aliya Naheed, Aamir H Khan, Anuradhani Kasturiratne, John D Clemens, Ching Wee Lim, Alun D Hughes, Nish Chaturvedi and 1 more

Registry-linked trialOpen access · bronzeAbstract readRandomized Controlled Trial
In one paragraph

Trial report in American journal of hypertension, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02657746 (Control of Blood Pressure and Risk Attenuation-Bangladesh, Pakistan and Sri Lanka), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.5field-weighted citation impact, top 35% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT02657746 naunknown statusnot on this map

Control of Blood Pressure and Risk Attenuation-Bangladesh, Pakistan and Sri Lanka (COBRA-BPS)

TypeinterventionalSponsorDuke-NUS Graduate Medical SchoolRan2016 to 2020Enrolled2,550ConditionsHypertensionArmsmulti-component interventions
3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 4 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 7 institutions in 6 countries.

Liang FengProgram in Health Services & Systems Research, Duke-NUS Medical School, Singapore.
Imtiaz JehanDepartment of Community Health Science, Aga Khan University, Karachi, Pakistan.
H Asita de SilvaClinical Trials Unit, Department of Pharmacology, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka.
Aliya NaheedThe International Center for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh.
Aamir H KhanSection of Cardiology, Department of Medicine, Aga Khan University, Karachi, Pakistan.
Anuradhani KasturiratneDepartment of Public Health, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka.
John D ClemensThe International Center for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh.
Ching Wee LimProgram in Health Services & Systems Research, Duke-NUS Medical School, Singapore.
Alun D HughesMRC Unit for Lifelong Health and Ageing, Institute of Cardiovascular Science, University College London, London, UK.
Nish ChaturvediMRC Unit for Lifelong Health and Ageing, Institute of Cardiovascular Science, University College London, London, UK.
Tazeen H JafarProgram in Health Services & Systems Research, Duke-NUS Medical School, Singapore.
Aga Khan University · PKDuke-NUS Medical School · SGInternational Centre for Diarrhoeal Disease Research · BDUniversity of Kelaniya · LKMRC Unit for Lifelong Health and Ageing · GBSingapore General Hospital · SGUniversity College London · GB

Funding

Department of HealthMedical Research CouncilWellcome Trust
6 · The paper itself

Abstract

backgroundInadequate treatment of hypertension is a widespread problem, especially in South Asian countries where cardiovascular disease mortality rates are high. We aimed to explore the effect of a multicomponent intervention (MCI) on antihypertensive medication intensification among rural South Asians with hypertension.

methodsA post hoc analysis of a 2-year cluster-randomized controlled trial including 2,645 hypertensives aged ≥40 years from 30 rural communities, 10 each, in Bangladesh, Pakistan, and Sri Lanka. Independent assessors collected information on participants' self-reports and physical inspection of medications. The main outcomes were the changes from baseline to 24 months in the following: (i) the therapeutic intensity score (TIS) for all (and class-specific) antihypertensive medications; (ii) the number of antihypertensive medications in all trial participants.

resultsAt 24 months, the mean increase in the TIS score of all antihypertensive medications was 0.11 in the MCI group and 0.03 in the control group, with a between-group difference in the increase of 0.08 (95% confidence interval (CI, 0.03, 0.12); P = 0.002). In MCI compared with controls, a greater increase in the TIS of renin-angiotensin-aldosterone system blockers (0.05; 95% CI (0.02, 0.07); P < 0.001) and calcium channel blockers (0.03; 95% CI (0.00, 0.05); P = 0.031), and in the number of antihypertensive medications (0.11, 95% CI (0.02, 0.19); P = 0.016) was observed.

conclusionsIn rural communities in Bangladesh, Pakistan, and Sri Lanka, MCI led to a greater increase in antihypertensive medication intensification compared with the usual care among adults with hypertension. CLINICAL TRIALS REGISTRATION: Trial Number NCT02657746.

Indexed as

Antihypertensive AgentsHypertensionRural PopulationAdultAsiaHumansTreatment OutcomeAntihypertensive Agentsblood pressurecommunity health workershypertensionmedications intensificationmulticomponent interventionphysiciansSouth Asia

Identifiers

PMID34013966
PMCPMC8457433
OpenAlexW3162555332

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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.