Can CHW telehealth beat clinic HTN visits?
In a 200-person pilot RCT in rural Kenya/Uganda, home CHW-facilitated clinician telehealth achieved 77% vs 51% BP control at 24 weeks (RD 26%).
Source
Community health worker-facilitated telehealth for moderate-severe hypertension care in Kenya and Uganda: A randomized controlled trial
Study at a glance
- Design
- RCT — CHW-facilitated telehealth vs clinic follow-up for moderate–severe hypertension in Kenya and Uganda
- N
- N=200 · 98 telehealth and 102 clinic; adults ≥40 with BP ≥160/100 at CHW screen
- Population
- Community-screened adults with moderate-to-severe hypertension in Kenya and Uganda
- Outcome
- Week-24 hypertension control after telehealth versus clinic follow-up
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Can CHW telehealth beat clinic HTN visits?
These passages occur verbatim in the stored paper text. They support the points listed below; they do not verify every statement in the explanation.
200 enrolled (98 telehealth, 102 clinic).
enrolling 200 (98 telehealth arms, 102 clinic arms)
24-week control 77% vs 51% (RD 26%, 95% CI 14–38%).
week 24 hypertension control was 77% in telehealth and 51% in clinic arms (risk difference (RD) 26%, 95% confidence interval (CI) [14%, 38%], p < 0.001)
What they did
Screened community adults ≥40 with BP ≥160/100 via CHWs, randomized 200 to clinician-driven telehealth facilitated at home by CHWs versus usual clinic-based hypertension care, and compared BP control at 24 and 48 weeks by ITT.
What they found
Week-24 control was 77% telehealth vs 51% clinic (RD 26%, 95% CI 14–38%, p<0.001); week-48 was 86% vs 44% (RD 42%). Cohort was 67% women, median age 62, 14% living with HIV. Three deaths occurred (unrelated to the intervention).
The limits
What it doesn't show
Small pilot limits scale-up inference; unblinded assignment and implementation costs/generalizability need larger trials.
Key terms
- CHW
- Community health worker facilitating home visits and BP care.
- Telehealth hypertension care
- Remote clinician counseling/decision-making with CHW support.
- BP control
- Blood pressure <140/90 mmHg in this trial.
- Moderate–severe hypertension
- Screening BP ≥160/100 mmHg here.
- Risk difference
- Absolute percentage-point gap in control between arms.
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Trial N randomized:
Common questions
Sample size / arms?
200 total (98 telehealth, 102 clinic).
Primary endpoint?
BP <140/90 at 24 weeks.
24-week control rates?
77% telehealth vs 51% clinic (RD 26%).
Where?
Rural Uganda and Kenya government primary care settings.