Trial reportBMJ open quality2025
Supportive supervision visits in a large community hypertension programme in Nigeria: implementation methods and outcomes.
Trial report in BMJ open quality, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04158154 (Transforming Hypertension Treatment in Nigeria Using a Type II Hybrid, Interrupted Time Series Design), which is not on this map. Cited by 10 papers.
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.
Transforming Hypertension Treatment in Nigeria Using a Type II Hybrid, Interrupted Time Series Design
Who cites it
10 citing papers in PubMed.
- Trial
- Implementation outcomes from the Hypertension Treatment in Nigeria program: results from a type 2 hybrid interrupted time series trial.Implementation science : IS · 2025Trial
- The evolution of supportive supervision in low- and middle-income countries.BMC global and public health · 2026Review
- Impact evaluation of the Hypertension Treatment in Nigeria program using the Translational Science Benefits Model.Journal of clinical and translational science · 2026Article
- Capacity and site readiness for hypertension control program implementation in Nigeria: A nationwide cross-sectional study.PloS one · 2026Article
- Implementation fidelity of Ethiopia's Malaria test-and-treat guideline amid a resurgence in Amhara Region: A mixed-methods study.PloS one · 2026Article
- Implementation, integration, and institutionalization of a community-based strategy for hypertension control in Colombia: the RE-HOPE implementation study protocol.Frontiers in cardiovascular medicine · 2026Article
- Article
- Implementation science aims to improve healthcare by validating effective interventions.Proceedings of the National Academy of Sciences of the United States of America · 2025Article
- Home blood pressure monitoring and equity challenges of the 2025 ACC/AHA hypertension guideline in Africa.The Pan African medical journal · 2025Article
Corrections and comments
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Authors and funding
14 authors.
Funding
Abstract
backgroundThe Hypertension Treatment in Nigeria (HTN) Programme established a system for hypertension diagnosis and management in 60 public primary healthcare facilities in the Federal Capital Territory of Nigeria through the implementation of HEARTS, a multi-level strategy bundle including team-based care led by community health extension workers (CHEWs). To improve HEARTS implementation, supportive supervision was added as an implementation strategy in April 2020.
methodsA multidisciplinary supportive supervision team and data collection forms were developed and implemented at HTN-supported sites. Data from April 2020 to December 2023 from supportive supervision visits were used to measure supportive supervision implementation outcomes, including reach, fidelity, adoption and feasibility and effectiveness of quality of care, data reporting and facility readiness. Descriptive analyses were performed to summarise outcomes. Jonckheere-Terpstra or Cochran-Armitage trend test was used to measure change over time for medians or proportions, respectively.
resultsThe programme successfully designed and performed quarterly supportive supervision visits. There was high reach (100% sites with visits each year), fidelity (median 100% (IQR 89%-100%) of core components completed), adoption (100% teams provided quarterly visits) and increase in feasibility (planned visits completed) (90.8% to 97.8%, p=0.002). Effectiveness outcomes included an increase in patients with blood pressure (BP) checked in the last 3 days (78.4% to 84.4%, p=0.009), treatment cards without errors (71.5% to 85%. p<0.001), but a slight drop in CHEW fidelity to BP measurement technique (91.5% to 86.5%, p=0.02). Facility readiness increased in adequate staffing (56.7% to 98.3%, p<0.001), but decreased for equipment availability (98.3% to 90.0%, p=0.03). Overall, the proportion of facilities with all readiness components present increased from 0% to 63.3% (p<0.001).
conclusionsWe designed and implemented a supportive supervision strategy with strong implementation outcomes and most effectiveness outcomes including facility readiness to provide quality hypertension care in Nigeria. This approach can be modelled for supporting HEARTS implementation in other settings. TRIAL REGISTRATION NUMBER: The trial was prospectively registered at www. CLINICALTRIALS: gov under NCT04158154 on 8 November 2019; https://clinicaltrials.gov/ct2/show/NCT04158154.
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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.