Evidence map›Paper›PMID 34637478›Full record

Trial reportPloS one2021

Effectiveness of community-based health education and home support program to reduce blood pressure among patients with uncontrolled hypertension in Nepal: A cluster-randomized trial.

Mahesh Kumar Khanal, Pratiksha Bhandari, Raja Ram Dhungana, Pratik Bhandari, Lal B Rawal, Yadav Gurung, K N Paudel, Amit Singh, Surya Devkota, Barbora de Courten

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02981251 (Effectiveness of Community Based Health Education in Reduction of Blood Pressure Among Uncontrolled Hypertensive Patients of Suburban Population of Surkhet District of Nepal), which is not on this map. Cited by 14 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 2 pooled it
–field-weighted citation impact
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.

NCT02981251 nacompletednot on this map

Effectiveness of Community Based Health Education in Reduction of Blood Pressure Among Uncontrolled Hypertensive Patients of Suburban Population of Surkhet District of Nepal

TypeinterventionalSponsorBheri Zonal Ayurveda HospitalRan2016 to 2017Enrolled142ConditionsHypertensionArmsHealth education with support by trained female health volunteer
3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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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

10 authors.

Mahesh Kumar KhanalProvincial Ayurveda Hospital, Ministry of Health and Population, Lumbini Province, Nepal.ORCID 0000-0001-5324-2802
Pratiksha BhandariRapti Life Care Hospital Pvt. Lt. Tulsipur, Dang, Nepal.
Raja Ram DhunganaInstitute for Health and Sport, Victoria University, Melbourne, Australia.
Pratik BhandariFaculty of SEBE, Deakin University, Warun Ponds, VIC, Australia.
Lal B RawalSchool of Health, Medical and Applied Sciences, College of Science and Sustainability, Central Queensland University, Sydney Campus, Australia.
Yadav GurungChild and Youth Health Research Center, Auckland University of Technology, Auckland, New Zealand.
K N PaudelProvince Hospital, Ministry of Social Development, Karnali Province, Surkhet, Nepal.
Amit SinghProvince Hospital, Ministry of Social Development, Karnali Province, Surkhet, Nepal.
Surya DevkotaDepartment of Cardiology, Manmohan Cardiothoracic Vascular and Transplant Centre, Institute of Medicine, Tribhuvan University, Kirtipur, Nepal.
Barbora de CourtenDepartment of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHypertension is a major global public health problem. Elevated blood pressure can cause cardiovascular and kidney diseases. We assessed the effectiveness of health education sessions and home support programs in reducing blood pressure among patients with uncontrolled hypertension in a suburban community of Nepal.

methodsWe conducted a community-based, open-level, parallel-group, cluster randomized controlled trial in Birendranagar municipality of Surkhet, Nepal. We randomly assigned four clusters (wards) into intervention and control arms. We provided four health education sessions, frequent home and usual care for intervention groups over six months. The participants of the control arm received only usual care from health facilities. The primary outcome of this study was the proportion of controlled systolic blood pressure (SBP). The analysis included all participants who completed follow-up at six months.

results125 participants were assigned to either the intervention (n = 63) or the control (n = 62) group. Of them, 60 participants in each group completed six months follow-up. The proportion of controlled SBP was significantly higher among the intervention participants compared to the control (58.3% vs. 40%). Odds ratio of this was 2.1 with 95% CI: 1.01-4.35 (p = 0.046) and that of controlled diastolic blood pressure (DBP) was 1.31 (0.63-2.72) (p = 0.600). The mean change (follow-up minus baseline) in SBP was significantly higher in the intervention than in the usual care (-18.7 mmHg vs. -11.2 mmHg, p = 0.041). Such mean change of DBP was also higher in the intervention (-10.95 mmHg vs. -5.53 mmHg, p = 0.065). The knowledge score on hypertension improved by 2.38 (SD 2.4) in the intervention arm, which was significantly different from that of the control group, 0.13 (1.8) (p<0.001).

conclusionsMultiple health education sessions complemented by frequent household visits by health volunteers can effectively improve knowledge on hypertension and reduce blood pressure among uncontrolled hypertensive patients at the community level in Nepal.

trial registrationClinicalTrial.gov: NCT02981251.

Indexed as

Health EducationProgram EvaluationAdultBlood PressureBody Mass IndexFemaleFollow-Up StudiesHealth FacilitiesHumansHypertensionKnowledgeMaleMiddle AgedNepalOdds Ratio

Identifiers

PMID34637478
PMCPMC8509872

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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.