Panimaquib

Researchers are evaluating a new approach to managing hypertension in rural Guatemala by comparing care led by community health workers (CHWs) supported by a mobile health application and remote physician supervision to traditional physician-led care. The study aims to determine if CHW-led management is not less effective than physician care in improving systolic blood pressure. This trial also explores the safety, patient acceptance, and cost of this CHW-led care model. The study will last between 12 and 24 months. Participants assigned to the CHW group will receive care guided by a mobile Clinical Decision Support (CDS) application called CommCare, which follows guidelines from the World Health Organization and the International Society of Hypertension for medication management and lifestyle advice. CHWs will be remotely supervised by physicians through teleconsultation. The physician-led care group will use the CommCare app without the CDS feature to record and review patient information but will not receive decision support from it. Those who join the study will have their systolic blood pressure measured at the start, then again at 6 months, and potentially at 12, 18, and 24 months depending on their time in the study. Researchers will monitor blood pressure changes over time to compare the two types of care. The study will also assess safety and how well patients accept the CHW-led approach. Participants must be adults with hypertension, able to provide consent, and will be followed closely during the study period.