TY - JOUR
T1 - Adapting a club-based medication delivery strategy to a hypertension context
T2 - The CLUBMEDS Study in Nigeria
AU - Santo, Karla
AU - Isiguzo, Godsent C.
AU - Atkins, Emily
AU - Mishra, Shiva R.
AU - Panda, Rajmohan
AU - Mbau, Lilian
AU - Fayomi, Samuel B.
AU - Ugwu, Collins
AU - Odili, Augustine
AU - Virani, Salim
N1 - Funding Information:
Funding The CLUBMEDS study is supported by a World Heart Federation Emerging Leaders Programme pilot funding grant.
Funding Information:
1Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia 2Cardiovascular Division, The George Institute for Global Health, Sydney, Australia 3Department of Medicine, University of Cape Town, Cape Town, South Africa 4Department of Medicine, Federal Teaching Hospital Abakaliki, Abakaliki, Nigeria 5Division of Epidemiology and Biostatistics, Faculty of Medicine, The University of Queensland, Brisbane, Australia 6Nepal Development Society, Bharatpur, Nepal 7Department of Research, Public Health Foundation of India, New Delhi, India 8Amref Health Africa, Nairobi, Kenya 9Primary Health Centre Awkuzu, Awkuzu, Nigeria 10University of Abuja, Abuja, Nigeria 11Department of Medicine - Cardiology, Baylor College of Medicine, Houston, USA Acknowledgements The authors thank the World Heart Federation Emerging Leaders Programme and Committee who supported and peer-reviewed the content of this research. In particular, the authors thank Mark Huffman, Pablo Perel and Karen Sliwa for their support and enthusiasm. The authors also thank the local staff at the rural and urban primary healthcare facilities for their engagement in this research.
Publisher Copyright:
© 2019 Author(s).
PY - 2019/7/1
Y1 - 2019/7/1
N2 - Introduction: The prevalence of hypertension in sub-Saharan Africa is among the world's highest; however, awareness, treatment and control of hypertension in this region are suboptimal. Among other barriers, the overburdened healthcare system poses a great challenge for hypertension control. Community peer-support groups are an alternative and promising strategy to improve adherence and blood pressure (BP) control. The CLUBMEDS study aims to evaluate the feasibility and impact of adherence clubs to improve hypertension control in Nigeria. Methods and analysis: The CLUBMEDS study will include a formative (pre-implementation) qualitative evaluation, a pilot study and a process (postimplementation) qualitative evaluation. At the formative stages, focus group discussions with patient groups and in-depth interviews with healthcare providers, managers and key decision makers will be conducted to understand the feasibility, barriers and facilitators, opportunities and challenges for the successful implementation of the CLUBMEDS strategy. The CLUBMEDS pilot study will be implemented in two primary healthcare facilities, one urban and one rural, in Southeast Nigeria. Each adherence club, which consists of a group of 10-15 patients with hypertension under the leadership of a role-model patient, serves as a support group to encourage and facilitate adherence, BP self-monitoring and medication delivery on a monthly basis. A process evaluation will be conducted at the end of the pilot study to evaluate the acceptability and engagement with the CLUBMEDS strategy. To date, 104 patients were recruited and grouped into nine clubs, in which patients will be followed-up for 6 months. Ethics and dissemination The study was approved by the University of Abuja Teaching Hospital and the Federal Teaching Hospital Abakaliki Human Research Ethics Committees and all patients provided informed consent. Our findings will provide preliminary data on the potential effectiveness and acceptance of this strategy in a hypertension context. Study findings will be disseminated via scientific forums.
AB - Introduction: The prevalence of hypertension in sub-Saharan Africa is among the world's highest; however, awareness, treatment and control of hypertension in this region are suboptimal. Among other barriers, the overburdened healthcare system poses a great challenge for hypertension control. Community peer-support groups are an alternative and promising strategy to improve adherence and blood pressure (BP) control. The CLUBMEDS study aims to evaluate the feasibility and impact of adherence clubs to improve hypertension control in Nigeria. Methods and analysis: The CLUBMEDS study will include a formative (pre-implementation) qualitative evaluation, a pilot study and a process (postimplementation) qualitative evaluation. At the formative stages, focus group discussions with patient groups and in-depth interviews with healthcare providers, managers and key decision makers will be conducted to understand the feasibility, barriers and facilitators, opportunities and challenges for the successful implementation of the CLUBMEDS strategy. The CLUBMEDS pilot study will be implemented in two primary healthcare facilities, one urban and one rural, in Southeast Nigeria. Each adherence club, which consists of a group of 10-15 patients with hypertension under the leadership of a role-model patient, serves as a support group to encourage and facilitate adherence, BP self-monitoring and medication delivery on a monthly basis. A process evaluation will be conducted at the end of the pilot study to evaluate the acceptability and engagement with the CLUBMEDS strategy. To date, 104 patients were recruited and grouped into nine clubs, in which patients will be followed-up for 6 months. Ethics and dissemination The study was approved by the University of Abuja Teaching Hospital and the Federal Teaching Hospital Abakaliki Human Research Ethics Committees and all patients provided informed consent. Our findings will provide preliminary data on the potential effectiveness and acceptance of this strategy in a hypertension context. Study findings will be disseminated via scientific forums.
KW - adherence clubs
KW - anti-hypertensives
KW - hypertension
KW - medication adherence
KW - peer-support groups
UR - http://www.scopus.com/inward/record.url?scp=85068848036&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2019-029824
DO - 10.1136/bmjopen-2019-029824
M3 - Article
C2 - 31289095
AN - SCOPUS:85068848036
SN - 2044-6055
VL - 9
JO - BMJ Open
JF - BMJ Open
IS - 7
M1 - e029824
ER -
