Home Blood Pressure Control Program Yields meaningful Results in Rural South Africa
MBABANE, Eswatini – A new study demonstrates that a program delivering blood pressure medication and monitoring directly to patients’ homes in rural South Africa considerably lowered systolic blood pressure, offering a potential model for expanding hypertension care in resource-limited settings. The findings, published recently, suggest community health workers (CHWs) can effectively manage hypertension outside of customary clinical environments.
The IMPACT-BP trial,conducted in rural kwazulu-Natal,showed a mean reduction in systolic blood pressure of approximately 16 mm Hg among participants receiving home-based care. This contrasts with results from similar interventions in other low- and middle-income countries, such as the COBRA-BPS study led by Dr. Tazeen Jafar, which reported a mean reduction of about 5 mm Hg. Dr. Jafar suggests the larger impact of IMPACT-BP might potentially be linked to the dedicated nature of the CHW roles and the provision of free medication. In COBRA-BPS, CHWs where employed by the public health sector and performed other duties, and medications were not provided at no cost.
The IMPACT-BP intervention utilized nurses to prescribe medications,a practice not universally available. Researchers acknowledge this as a potential barrier to widespread implementation and emphasize the need to expand patient recruitment beyond clinic settings to reach individuals not actively seeking healthcare. “many people with hypertension are not seeking care at healthcare facilities,” noted dr. Jafar.
Despite these challenges, experts hail IMPACT-BP as a crucial step forward. “Community health workers are a readily available resource in many low- and middle-income countries, and they can be leveraged upon to scale up the intervention,” Dr. Jafar stated. She anticipates that integrating the program into existing health systems may lead to some attenuation of the observed benefits,but maintains the approach holds promise even for underserved populations in higher-income countries.
