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hypertension

Can CHW telehealth beat clinic HTN visits?

Hickey MD, Owaraganise A, Ogachi S, et al. · PLoS medicine · 2025

Open access · cc by · source: Europe PMC

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%).

Key findings

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).

Methodology

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.

Limitations

Small pilot limits scale-up inference; unblinded assignment and implementation costs/generalizability need larger trials.

How this study connects

Role on claims

Each row is a claim on a concept or method page where this paper supports, challenges, or qualifies the statement. Roles are hand-checked — not a model guess.

  • SupportsTelemedicineconcept

    CHW-facilitated telehealth can beat usual clinic BP control in moderate–severe hypertension.

    A Kenyan pilot found week-24 hypertension control 77% with CHW-facilitated telehealth versus 51% clinic (RD 26%, 95% CI 14–38%); week-48 gaps widened further.

    Evidence for the claim as stated.

  • SupportsTelemedicineconcept

    Acute virtual COVID pathways and chronic hypertension telehealth pilots answer different delivery questions; success in one setting is not automatic proof for the other.

    Evidence for the claim as stated.

Open questions

Tensions this paper is part of

From concept pages' “where studies disagree.” Disagreement means the same question; scope means different assays, populations, or outcomes.

  • Scope difference — different assays, populations, or outcomes

    SupportsTelemedicine

    Acute virtual COVID pathways and chronic hypertension telehealth pilots answer different delivery questions; success in one setting is not automatic proof for the other.

History

When this study was placed

Dated entries from the concept change log — when this paper was added or removed as support, challenge, or qualifier on a claim.

  1. 2026-09-15

    Placed as supporting evidence on Telemedicine

    A Kenyan pilot found week-24 hypertension control 77% with CHW-facilitated telehealth versus 51% clinic (RD 26%, 95% CI 14–38%); week-48 gaps widened further.

  2. 2026-09-15

    Placed as supporting evidence on Telemedicine

    Acute virtual COVID pathways and chronic hypertension telehealth pilots answer different delivery questions; success in one setting is not automatic proof for the other.

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Same topic cluster — not a recommendation engine.