Panimaquib

Researchers are evaluating a new approach to managing hypertension in adults living in rural Guatemala. The study compares care led by community health workers CHWs using a mobile health application and remote doctor supervision to traditional care provided directly by physicians. This trial aims to find out if the CHW-led care is not worse than physician care in improving systolic blood pressure. The study also assesses the safety, patient acceptance, and cost of this innovative care model. Participants in the CHW-led group will receive monthly visits where trained health workers use a mobile clinical decision support system to guide medication management, lifestyle advice, and monitor for complications. Physicians provide remote oversight through teleconsultations. For patients with both hypertension and diabetes, CHWs will also manage blood sugar treatment using the application. The physician care group will receive management following the same clinical protocols but without decision support from the mobile app. Participants will be followed for 12 to 24 months, with blood pressure and other health measures checked at baseline, 6 months, 12 months, and for some participants up to 24 months. Outcomes include changes in systolic blood pressure, achievement of blood pressure goals, and various health markers such as cholesterol, kidney function, weight, and diabetes control. The study also collects data on medication adherence, lifestyle habits, and patient satisfaction to understand the overall impact of care. Safety and treatment effectiveness will be monitored throughout the trial.