The overall quality of evidence based on GRADE criteria was moderate for systolic blood pressure , but low for diastolic blood pressure .
INTERPRETATION Task-sharing interventions are effective in reducing blood pressure .
BACKGROUND Task sharing for the management of hypertension could be useful for understaffed and re source -poor health systems .
We assessed the effectiveness of task-sharing interventions in improving blood pressure control among adults in low-income and middle-income countries .
Phone-based intervention for blood pressure control among Ghanaian stroke survivors: A pilot randomized controlled trial
Background The potential of mobile-health ( mHealth ) technology for the management of hypertension among stroke survivors in Africa remains unexplored . We assessed whether an mHealth technology-enabled , nurse-guided intervention initiated among stroke patients within one month of symptom onset is effective in improving their blood pressure ( BP ) control . Methods A two-arm pilot cluster r and omized controlled trial involving 60 stroke survivors , ≥18 years , with BP ≥140/90 mmHg at screening/enrollment visit at a medical center in Ghana . Participants in the intervention arm ( n = 30 ) received a Blue-toothed BP device and smartphone with an App for monitoring BP measurements and medication intake under nurse guidance for three months after which intervention was withdrawn . Control arm ( n = 30 ) received usual care . Primary outcome measure was proportion with clinic BP < 140/90 mmHg at month 9 ; secondary outcomes included medication adherence . Findings Mean ± SD age was 55 ± 13 years , 65 % males . Two participants on intervention and three in control group were lost to follow-up . At month 9 , proportion on the intervention versus controls with BP < 140/90 mmHg was 14/30 ( 46.7 % ) versus 12/30 ( 40.0 % ) , p = 0.79 by intention-to-treat ; systolic BP < 140 mmHg was 22/30 ( 73.3 % ) versus 13/30 ( 43.3 % ) , p = 0.035 . Mean ± SD medication possession ratio was 0.95 ± 0.16 on intervention versus 0.98 ± 0.24 in the control arm , p = 0.56 . Interpretation We demonstrate feasibility and signal of improvement in BP control  among stroke survivors in a re source -limited setting via an mHealth intervention . Larger scale studies are warranted . Trial registration NCT02568137 . Registered on 13 July 2015 at Clinical Trials.gov
The overall quality of evidence based on GRADE criteria was moderate for systolic blood pressure , but low for diastolic blood pressure .
INTERPRETATION Task-sharing interventions are effective in reducing blood pressure .
BACKGROUND Task sharing for the management of hypertension could be useful for understaffed and re source -poor health systems .
We assessed the effectiveness of task-sharing interventions in improving blood pressure control among adults in low-income and middle-income countries .