"Community-based, eHealth Supported Management of Cardiovascular Risk Factors by Lay Village Health Workers (ComBaCaL aHT TwiC 1 & ComBaCaL aHT TwiC 2)
Arterial Hypertension
About this trial
This is an interventional health services research trial for Arterial Hypertension focused on measuring Community-Based Chronic Disease Care Lesotho (ComBaCaL) cohort study, low- and middle-income countries (LMICs), facility-based healthcare professionals, lay healthcare workers (LHWs), community-based aHT care models, chronic care village health workers (CC-VHWs), Lesotho Ministry of Health (MoH) Village Health Worker Program, village-based prescription, chronic care nurses (CC nurses), non-communicable diseases (NCDs), cardiovascular disease (CVD)
Eligibility Criteria
Inclusion Criteria ComBaCaL-TwiC 1: Participant of the ComBaCaL cohort study (signed informed consent available) Living with aHT, defined as reporting intake of antihypertensive medication or being newly diagnosed during screening via standard diagnostic algorithm BP ≥140/90 mmHg at baseline Inclusion criteria ComBaCaL-TwiC 2 Participant of the ComBaCaL cohort study (signed informed consent available) Reporting intake of antihypertensive medication BP<140/90 mmHg at baseline Exclusion Criteria for both ComBaCaL-TwiC 1&2: Reported pregnancy (at baseline or during follow-up)
Sites / Locations
- SolidarMed LesothoRecruiting
- University Hospital Basel, Division of Clinical EpidemiologyRecruiting
Arms of the Study
Arm 1
Arm 2
Active Comparator
Active Comparator
Intervention villages
Control villages
CC-VHWs do screen, diagnosis, first-line aHT treatment for eligible participants, treatment monitoring at community-level (ComBaCaL app guides them to provide first-line antihypertensive SPCs to eligible individuals and treatment monitoring/ support to all individuals with aHT). CC- VHW offers lifestyle counselling, lipid -lowering treatment to participants with high CVD risk and antiplatelet treatment to participants with history of stroke/ myocardial infarction. Trained, supervised, mentored by chronic care nurses (CC nurses) and guided by the ComBaCaL app they follow-up persons with aHT to monitor adherence, life-style changes, treatment response, side-effects. TwiC 1: individuals with uncomplicated aHT (baseline BP above treatment targets) TwiC 2: individuals with uncomplicated pharmacologically controlled aHT. In case of complicated disease or presence of clinical alarm signs/ symptoms, participants are referred to the closest health facility for further investigation.
Control villages will follow the standard of care in the ComBaCaL cohort study. CC-VHWs will also receive tablets with the ComBaCaL app installed. They are trained, supervised and equipped to screen and diagnose aHT with subsequent referral to facility-based follow-up and care. In control villages the ComBaCaL app supports clinical decision making and documentation for screening, diagnosis and referral, but not prescription/ provision of antihypertensive or lipid-lowering medication. TwiC 1: enrols individuals with uncomplicated aHT with baseline BP values above treatment targets. TwiC 2: enrols individuals with uncomplicated pharmacologically controlled aHT. In case of complicated hypertension or presence of clinical alarm signs or symptoms, participants will be immediately referred to the closest health facility for further investigation.