Community-based HyPertension Control (CHPC) in Nepal: Cluster randomized implementation trial protocol

This study evaluates the implementation and effectiveness outcomes of a community-based hypertension control intervention in Nepal. Researchers aim to assess how well the intervention improves blood pressure management compared to standard care and explores its adoption, implementation fidelity, and sustainability within existing healthcare systems.

Hypertension is a leading cause of preventable death worldwide, with significant impacts in low- and middle-income countries like Nepal. In Nepal, 25% of adults are affected, yet most remain undiagnosed or inadequately treated. This study addresses barriers to hypertension management, such as low health literacy, cultural misconceptions, and limited healthcare access, by empowering Female Community Health Volunteers (FCHVs) to deliver education, monitor blood pressure, and support medication adherence. Effective implementation could reduce hypertension-related deaths and improve health outcomes for underserved populations.

The researchers are conducting a cluster randomized trial in Sindhupalchowk, Nepal, involving 102 health facilities. Half were assigned to the intervention group, which implemented community-based blood pressure monitoring, lifestyle counseling, and medication adherence support led by FCHVs. Participants include 3,572 adults aged 30 and older with hypertension. The study is using the RE-AIM framework to evaluate implementation outcomes, including reach, adoption, and maintenance. Clinical effectiveness will be assessed by comparing changes in systolic blood pressure between intervention and control groups after 12 months.

No findings were reported in this publication.

This study highlights the potential of community health workers to address critical barriers in hypertension management, such as limited access to healthcare and cultural misconceptions. If shown to be effective and scalable, this model could improve blood pressure control in low-resource settings, reduce cardiovascular disease risks, and lower healthcare costs. It also demonstrates how task-shifting to trained community volunteers can enhance healthcare delivery for chronic conditions.

The key findings of this study will be reported in a future publication. The researchers recommend further studies to explore long-term sustainability and cost-effectiveness of the intervention. They also suggest investigating the scalability of this approach across diverse regions in Nepal and its applicability to managing other chronic conditions, such as diabetes and cardiovascular disease.

This research was supported by the National Institutes of Health (Project number: 1R01HL169421). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.