DOI: 10.5061/dryad.76hdr7t1n
title: Retrospective cohort study of a community-based primary care program's effects on pharmacotherapy quality in low-income Peruvians with type 2 diabetes and hypertension

description: A door-to-door survey was conducted to enumerate all household members by
 age and sex in a low-income community in Peru. 856 adults 35 years and
 older were eligible to participate in screening for type 2 diabetes and
 hypertension. 709 (83%) participated in screening. 130 (18.3%) were
 diagnosed with hypertension and/or type 2 diabetes of which 109 (84%)
 participated at program onset and 22 were added later from earlier
 non-participants in screening or program onset to form the cohort of 131
 patients with diabetes and/or hypertension. The primary care program had
 components of the Chronic Care Model, community health workers, and freely
 accessible visits and medications. The program operated between September
 2011 and May 2014, and consisted of two care periods (separated by a
 six-month hiatus), first a 10-month home-care period, then a 17-month
 clinic-care period. The dataset is two files corresponding to two
 exposures: the 27-month program overall (post- versus pre-) (N=262
 observations, 131 pairs with patients as self-controls) and care period
 (clinic versus home), N=211 (109 home and 102 clinic observations,
 &gt;131 because 80 patients participated in both care periods).
 Exposures were evaluated for their effects on guidelines-based
 pharmacotherapy standards: hypoglycemic and antihypertensive medications,
 low-dose aspirin, and first-line angiotensin converting enzyme inhibitor
 (ACEi) treatment of diabetes with elevated blood pressure.
description: From 2011 to 2014, data was collected prospectively, during
 weekly (home visits) or monthly (clinic visits), on paper encounter forms
 that were entered into Microsoft Excel as part of the standard operation
 of the community-based program. In January 2020, the University of Arizona
 institutional review board approved the use of the de-identified data for
 a study of the program's effects on clinical outcomes. Time-series
 data (fasting glucose and blood pressure) was collapsed on the median of
 monthly average fasting glucose and blood pressure values during the
 program (27 months) and the respective care periods, home (10 months) and
 clinic (17 months). Antihypertensive and hypoglycemic agents were
 collapsed on the highest dose ever received, angiotensin-converting enzyme
 inhibitors (ACEi) and aspirin on whether any dose was ever received, by
 treatment-eligible groups, and within program and care period time
 intervals. Retention in care was obtained by counting visits and elapsed
 months (from first to last patient encounters) during the program and care
 periods. Treatment-eligible groups were low-dose aspirin candidates
 (10-year cardiovascular disease (CVD) risk &gt;=10% by the Framingham
 alternate model that uses clinical factors only, no laboratory factors;
 blood pressure (BP) treatment candidates (BP &gt;=130/80 mm Hg if
 diabetic or &gt;=140/90 mm Hg if non-diabetic); hypoglycemic agent
 candidates (patients with diabetes); and diabetic ACEi candidates
 (diabetes with BP &gt;=130/80 mm Hg). Data has been transformed into
 two files corresponding to two exposures: 1) program, post- versus pre-
 (referent), N=262 observations; and 2) care period, clinic versus home
 (referent), N=211 observations.  There
 are two data files in text (comma-delimited) format. Pre-post....csv
 contains the 262 observations for the program exposure. Care period....csv
 contains the 211 care period observations. Each file has a data dictionary
 also in comma-delimited format. "Pre-post data dict....csv"
 describes the variables in the program exposure study. "Care period
 data dict....csv" describes the variables in the care period exposure
 study. 
description: There are four files (two data and two data dictionaries), all in
 comma-delimited text format and a README.md file. 
description: # Retrospective cohort study of a community-based primary care
 program's effects on pharmacotherapy quality in low-income Peruvians
 with type 2 diabetes and hypertension There are two data files in text
 format (comma-delimited). Pre-post....csv contains the 262 observations
 for the program exposure. Care period....csv contains the 211 care period
 observations. Each file has a data dictionary, also in comma-delimited
 non-UTF-8 text format. "Pre-post data dict....csv" describes the
 variables in program exposure study. "Care period data
 dict....csv" describes the variables in the care period exposure
 study.  Usage notes There are four files (two data and two data
 dictionaries), all in comma-delimited text format (non-UTF-8) and a
 README.md file. *** ## Sharing/Access information There are no other ways
 to access the data. The data is not derived from any other source. ##
 Code/Software No coding or scripts are included with the data.