Improving Hypertension and Diabetes Care in Rural Bangladesh Using mHealth and Decentralized Primary Care The Dinajpur Study

What this Trial Is About

Researchers are evaluating a new approach to improve care for adults with hypertension and diabetes in rural Bangladesh. The study aims to understand how integrated, decentralized primary care involving training, mobile health mHealth technology, task shifting, and community-based care compares to usual care and mHealth alone. This research will explore how these methods affect treatment, prevention, patient lifestyle changes, and healthcare system costs over 36 months. The study includes three groups one receiving multicomponent decentralized care with mHealth support and community health worker involvement one receiving only mHealth intervention using the Simple App and one receiving usual government primary care. The multicomponent care combines training for providers, community clinic services, and supportive monitoring visits. The mHealth-only group uses the app for patient management without additional community care. Usual care involves standard screening and treatment at subdistrict health facilities. Participants will be monitored through community surveys and facility-based data collection over almost three years. Researchers will assess blood pressure and diabetes control, treatment steps, lifestyle factors, patient burdens like travel and wait times, and barriers to care. Evaluations include quantitative measures, qualitative interviews, and economic analysis to inform broader implementation. The primary outcome is control of hypertension and diabetes after 2 years and 9 months.

Addressing Gaps in the Hypertension and Diabetes Care Continuum in Rural Bangladesh: The Dinajpur Study