Table 2 Baseline characteristics of studies
Author and publication year | Study design | Country and setting | Name project/model of care | Participants (eligibility criteria) | Sample size (n) | Study period | Comparisons | Integration with other services | Use of eHealth technology | ||
|---|---|---|---|---|---|---|---|---|---|---|---|
Intervention | Intervention | ||||||||||
1 | Steyn et al. 1993 [62] | Prospective quasi-experimental study with cohort and cross-sectional elements | South Arica semiurban (defined by authors as rural) towns | CORIS | Hypertensive patients, 15-64y at baseline, 15-68y at endline | 7188 | 1979–1983 | •1 low intensity intervention town: use of small mass media (billboards, posters, pamphlets) to deliver messages in the community •1 high intensity intervention town: hypertensives, active follow up through community BP stations and exposure to media messages | •Control town | General counselling on lifestyle related to CVDRFs | None |
2 | Oparah et al. 2006 [60] | Prospective cohort study | Nigeria urban | - | Hypertensive patients ≥ 18y on aHT treatment | 42 | 2003–2004 | •1 community pharmacy: pharmacists provided BP monitoring, BMI measurement, medication education, lifestyle modifications, and assistance with treatment compliance | •N/A | No | Follow up through phone calls |
3 | Ndou et al. 2013 [51] | Retrospective case control study | South Africa urban | Kgatelopele programme | Stable patients with hypertension or diabetes Three-fold matched controls | 224 | NR | •Monthly home visits by one CHWs. Pharmacist pre-packed a month’s supply of medication for delivery. Patients visit the clinic every 6 months for a physical examination by a doctor who provides a renewed prescription | •Clinic-based standard of care | Diabetes | None |
4 | Khabala et al. 2015 [58] | Retrospective cohort study | Kenya urban | Medication Adherence Clubs for multiple chronic diseases | Stable patients with diabetes, hypertension and/or HIV | 1432 | 2013–2014 | •MACs are nurse-facilitated, mixed groups of 25–35 stable hypertension, diabetes and/or HIV patients •Nurses lead quarterly meetings in medication adherence clubs (MACs) in health facilities to confirm clinical stability, have brief health discussions and receive medication •Clinical officer reviewed MACs yearly when patients developed complications or no longer met stability criteria | •N/A | Diabetes and HIV | None |
5 | Marfo et al. 2017 [55] | Prospective non-randomized controlled trial | Ghana urban | - | Patients diagnosed with hypertension ≥ 6 months, with a review period of at least two months | 180 | NR | •Monthly follow up at 3 community pharmacies: BP monitoring, medicines use review, health education and adherence counselling •Follow up reminders via text messages and phone calls | •2 control community pharmacies | Diabetes | Follow up through SMS and phone calls |
6 | Nelissen et al. 2018 [61] | Prospective mixed-methods study | Nigeria urban | - | Hypertensive patients > 18y. SBP ≤ 180 mmHg and DBP ≤ 110 mmHg. No history of cardiac failure, stroke, or renal disease. No additional CVRF. Non-pregnant | 336 | 2016–2017 | •5 community pharmacies where staff and cardiologists provide joint care directly connected through a mobile application (mHealth) for remote patient monitoring •Task-shifting from medical doctors to pharmacy staff: pharmacy staff performed regular follow up, including BP measurements, medication and lifestyle counselling, visits reminders and communication with the cardiologist | •N/A | None | Patients, pharmacists, and cardiologists connected through a mobile application: mHealth |
7 | Kuria et al. 2018 [54] | Retrospective cohort study | Kenya urban | - | Hypertensive patients retained in clinics for at least 6 months | 785 | 2015–2016 | •Model of care adapted to give services to a transient community •Weekend clinics in churches offered comprehensive services between 0900 and 1600 h, on worship days • “Walkways”, drop-in-clinics offered comprehensive care, located on commonly used roadways outside or near the clinic operating between 1630 and 1830 h •CHVs take BP readings. A clinician supervises the CHVs, diagnoses, treats patients, and dispenses medication. Clinicians are drawn from project sites and work on a rotational basis •A patient booklet containing clinical information is issued to address patients mobility | •Regular services at health facilities | None | None |
8 | Adler et al. 2019 [52] | Prospective cohort study | Ghana semiurban/peri-urban | ComHIP study | Diagnosed hypertension in ≥ 18y, non-pregnant, with access to a mobile phone | 1339 | 2015–2016 | •Monthly BP monitoring appointments, review visits every 1,2 or 3 months depending on risk and personal factors •6-monthly follow up assessments at local drug shops or CHWs •Daily adherence reminders and weekly healthy living tips by SMS | •N/A | None | -Electronic database CommCare -Cloud-based health records system that links patients’ records with SMS system -SMS platform automatically sends daily adherence reminders, weekly healthy living tips, and consultation and prescription refill reminders to enrolled patients |
9 | Bolarinwa et al. 2019 [59] | Unblinded individual open RCT | Nigeria urban | - | Hypertensive adults on treatment | 299 | NR | •Monthly follow up visits at home conducted by nurses including counselling, education, family approaches and integration of other chronic conditions | •Usual care | Quality of Life, including physical and mental health components | None |
10 | Stephens et al. 2021 [53] | Retrospective cohort study | Uganda rural | CDCom program | SBP < 170 mmHg for 6 months. Good adherence. No renal or cardiovascular complications | 761 (413 on hypertension treatment) | 2016- 2019 | •Monthly meetings of patients with VHW and their clinician supervisors at places used for gatherings in the community, delivering integrated care •Content of meetings: treatment monitoring, lifestyle and medication adherence counselling, diagnosis of chronic complications. Referral to health facilities if necessary •BP treatment prioritization according to individual risk and adapted to minimize effects of drug stock outs | •N/A | Diabetes, heart disease, asthma, epilepsy and other NCDs | None |
11 | Otieno et al. 2021 [57] | Prospective cohort study | Kenya and Ghana Urban/rural | - | Hypertensive patients ≥ 18y | 1266 | 2018–2019 | •Weekly, bi-weekly, or monthly blood pressure assessments as determined by app or providers at community location, central employment location or home •In-clinic review visits every 30, 60 or 90 days •Digital application-generated personalized educational, supportive, and instructive messages | •N/A | None | -eHealth platform: Empower Health, stores patients’ records -Algorithm driven follow-up provides patients with personalized/risk-based care plans - Platform delivers educational/adherence/locally appropriate healthy lifestyle messages, based on the patient's enrolment risk classification, and follow up |
12 | Vedanthan et al. 2021 [56] | Cluster RCT | Kenya rural | BIGPIC | Hypertensive ≥ 35y patients not on treatment or on treatment < 6 m. No acute illness, non-pregnant or HIV-infected patients | 2890 | NR | •Monthly meetings in respective groups: -Usual care (UC) plus microfinance (MF) support -Group medical visits (GMV) -Group medical visits plus microfinance support (GMV-MF) •Group medical visits comprised monitoring and counselling | •Usual standard of care | Diabetes | None |