PHFI

The objective of the study is to test the effectiveness, cost effectiveness and cost utility of a decision-support system, in hypertensive patients attending primary health care (PHC) centers in a district of AP, India compared to Usual Care (UC) at the end of 12 months of follow up. Randomly chosen 8 PHCs, homogenous in age and gender distribution, from a district in AP, India would be cluster randomized to receive a DSS or UC. The cluster adjusted sample size is 784 subjects (8 clusters with 125 subjects in each cluster to allow for a 20% loss to follow up) per intervention arm to detect a 4mm Hg difference in Systolic Blood Pressure (SBP) with a power of 90% and an alpha of 0.05. Evaluation, risk stratification, guideline based pharmacological treatment and take home advice (on lifetsyle interventions and treatment adherance) would form the elements of DSS. Data on cardiovascular risk profiling and quality of life will be collected at 0, 6 and 12 months after randomization. The primary end point would be comparison of SBP at 0 and 12 months with comparison of quality of life scores and cost effectiveness (0 versus 12m) as secondary end points.

This research is being done as part of a PhD at University of Cambridge under the PHFI-UKC Wellcome Trust Capacity Building Programme.

PhD Scholar: Raghupathy Anchala
Supervisor: D. Prabhakaran (India), John Danesh & Dr. Oscar Franco (UK)