Adapting a club-based medication delivery strategy to a hypertension context: the CLUBMEDS Study in Nigeria

Introduction The prevalence of hypertension in sub-Saharan Africa is among the world’s highest; however, awareness, treatment and control of hypertension in this region are suboptimal. Among other barriers, the overburdened healthcare system poses a great challenge for hypertension control. Communit...

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Main Authors: Karla Santo, Godsent C Isiguzo, Emily Atkins, Shiva R Mishra, Rajmohan Panda, Lilian Mbau, Samuel B Fayomi, Collins Ugwu, Augustine Odili, Salim Virani
Format: Article
Language:English
Published: BMJ Publishing Group 2019-07-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/7/e029824.full
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author Karla Santo
Godsent C Isiguzo
Emily Atkins
Shiva R Mishra
Rajmohan Panda
Lilian Mbau
Samuel B Fayomi
Collins Ugwu
Augustine Odili
Salim Virani
author_facet Karla Santo
Godsent C Isiguzo
Emily Atkins
Shiva R Mishra
Rajmohan Panda
Lilian Mbau
Samuel B Fayomi
Collins Ugwu
Augustine Odili
Salim Virani
author_sort Karla Santo
collection DOAJ
description Introduction The prevalence of hypertension in sub-Saharan Africa is among the world’s highest; however, awareness, treatment and control of hypertension in this region are suboptimal. Among other barriers, the overburdened healthcare system poses a great challenge for hypertension control. Community peer-support groups are an alternative and promising strategy to improve adherence and blood pressure (BP) control. The CLUBMEDS study aims to evaluate the feasibility and impact of adherence clubs to improve hypertension control in Nigeria.Methods and analysis The CLUBMEDS study will include a formative (pre-implementation) qualitative evaluation, a pilot study and a process (postimplementation) qualitative evaluation. At the formative stages, focus group discussions with patient groups and in-depth interviews with healthcare providers, managers and key decision makers will be conducted to understand the feasibility, barriers and facilitators, opportunities and challenges for the successful implementation of the CLUBMEDS strategy. The CLUBMEDS pilot study will be implemented in two primary healthcare facilities, one urban and one rural, in Southeast Nigeria. Each adherence club, which consists of a group of 10–15 patients with hypertension under the leadership of a role-model patient, serves as a support group to encourage and facilitate adherence, BP self-monitoring and medication delivery on a monthly basis. A process evaluation will be conducted at the end of the pilot study to evaluate the acceptability and engagement with the CLUBMEDS strategy. To date, 104 patients were recruited and grouped into nine clubs, in which patients will be followed-up for 6 months.Ethics and dissemination The study was approved by the University of Abuja Teaching Hospital and the Federal Teaching Hospital Abakaliki Human Research Ethics Committees and all patients provided informed consent. Our findings will provide preliminary data on the potential effectiveness and acceptance of this strategy in a hypertension context. Study findings will be disseminated via scientific forums.
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spelling doaj-art-062c3a6931774b5fbfefb93d9bdaf9932024-11-23T07:15:09ZengBMJ Publishing GroupBMJ Open2044-60552019-07-019710.1136/bmjopen-2019-029824Adapting a club-based medication delivery strategy to a hypertension context: the CLUBMEDS Study in NigeriaKarla Santo0Godsent C Isiguzo1Emily Atkins2Shiva R Mishra3Rajmohan Panda4Lilian Mbau5Samuel B Fayomi6Collins Ugwu7Augustine Odili8Salim Virani9Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia3 Department of Medicine, University of Cape Town, Cape Town, South Africa2 Cardiovascular Division, The George Institute for Global Health, Sydney, Australia6 Nepal Development Society, Bharatpur, NepalResearch, Public Health Foundation of India, Gurgoan, Haryana, India8 Amref Health Africa, Nairobi, Kenya9 Primary Health Centre Awkuzu, Awkuzu, Nigeria4 Department of Medicine, Federal Teaching Hospital Abakaliki, Abakaliki, Nigeria10 University of Abuja, Abuja, Nigeria2 Department of Medicine, Baylor College of Medicine, Houston, Texas, USAIntroduction The prevalence of hypertension in sub-Saharan Africa is among the world’s highest; however, awareness, treatment and control of hypertension in this region are suboptimal. Among other barriers, the overburdened healthcare system poses a great challenge for hypertension control. Community peer-support groups are an alternative and promising strategy to improve adherence and blood pressure (BP) control. The CLUBMEDS study aims to evaluate the feasibility and impact of adherence clubs to improve hypertension control in Nigeria.Methods and analysis The CLUBMEDS study will include a formative (pre-implementation) qualitative evaluation, a pilot study and a process (postimplementation) qualitative evaluation. At the formative stages, focus group discussions with patient groups and in-depth interviews with healthcare providers, managers and key decision makers will be conducted to understand the feasibility, barriers and facilitators, opportunities and challenges for the successful implementation of the CLUBMEDS strategy. The CLUBMEDS pilot study will be implemented in two primary healthcare facilities, one urban and one rural, in Southeast Nigeria. Each adherence club, which consists of a group of 10–15 patients with hypertension under the leadership of a role-model patient, serves as a support group to encourage and facilitate adherence, BP self-monitoring and medication delivery on a monthly basis. A process evaluation will be conducted at the end of the pilot study to evaluate the acceptability and engagement with the CLUBMEDS strategy. To date, 104 patients were recruited and grouped into nine clubs, in which patients will be followed-up for 6 months.Ethics and dissemination The study was approved by the University of Abuja Teaching Hospital and the Federal Teaching Hospital Abakaliki Human Research Ethics Committees and all patients provided informed consent. Our findings will provide preliminary data on the potential effectiveness and acceptance of this strategy in a hypertension context. Study findings will be disseminated via scientific forums.https://bmjopen.bmj.com/content/9/7/e029824.full
spellingShingle Karla Santo
Godsent C Isiguzo
Emily Atkins
Shiva R Mishra
Rajmohan Panda
Lilian Mbau
Samuel B Fayomi
Collins Ugwu
Augustine Odili
Salim Virani
Adapting a club-based medication delivery strategy to a hypertension context: the CLUBMEDS Study in Nigeria
BMJ Open
title Adapting a club-based medication delivery strategy to a hypertension context: the CLUBMEDS Study in Nigeria
title_full Adapting a club-based medication delivery strategy to a hypertension context: the CLUBMEDS Study in Nigeria
title_fullStr Adapting a club-based medication delivery strategy to a hypertension context: the CLUBMEDS Study in Nigeria
title_full_unstemmed Adapting a club-based medication delivery strategy to a hypertension context: the CLUBMEDS Study in Nigeria
title_short Adapting a club-based medication delivery strategy to a hypertension context: the CLUBMEDS Study in Nigeria
title_sort adapting a club based medication delivery strategy to a hypertension context the clubmeds study in nigeria
url https://bmjopen.bmj.com/content/9/7/e029824.full
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