Key result
CHW-led mHealth hypertension management achieves high physician agreement and a ~8 mmHg reduction in SBP.
Why the study?
Hypertension is a leading global cause of morbidity and mortality, particularly in LMICs where limited healthcare access impedes management, but whether CHWs supported by mHealth CDS tools could help was uncertain.
Does CHW-led hypertension management using an mHealth CDS application improve blood pressure and provide feasible care in adults with hypertension in rural Guatemala?
Does CHW-led hypertension management using an mHealth CDS application improve blood pressure and provide feasible care in adults with hypertension in rural Guatemala?
A CHW-led mHealth clinical decision support intervention for hypertension management is feasible, safe, and associated with blood pressure reductions in a rural, low-resource setting.
Answers are grounded in this paper and cite their sources.
Supports feasibility of CHW-mHealth hypertension care in rural low-resource settings; leaves open efficacy versus usual care in randomized trials.
Background: Hypertension is a leading global cause of morbidity and mortality, especially in low- and middle-income countries (LMICs), where low health service access limits diagnosis and treatment. Community health workers (CHWs) supported by mobile health (mHealth) clinical decision support (CDS) tools may help. This study evaluated the feasibility of CHW-led hypertension management using an mHealth CDS application in rural Guatemala. Methods: We conducted a six-month, single-group feasibility study in rural San Lucas Tolimán, Guatemala. Trained CHWs used a CommCare-based CDS application wherein algorithms based on WHO HEARTS guided medication titration, lifestyle counseling, and physician consultation. Adults (≥18 years) with diagnosed hypertension were followed monthly for six months. The primary feasibility outcome was prescribing agreement between CHWs and supervising physicians with application antihypertensive recommendations (minimum acceptable agreement = 90%). Primary clinical outcomes were changes in systolic (SBP) and diastolic (DBP) blood pressure. Secondary outcomes included retention, visit completion, patient satisfaction, and safety. Results: Thirty-two participants were enrolled (84% female); 30 (93.8%) completed six-month follow-up, with 96.4% of possible visits completed. Overall CHW-physician agreement with application recommendations was 96.7%, increasing to 98.9% over the final three months. Median SBP decreased 7.5 mmHg (95% CI 1.0-12.0) and mean DBP 3.1 mmHg (95% CI 0.1-6.1). The proportion of patients with controlled SBP (<140 mmHg) increased from 66.7% to 76.7% (p = 0.505). Eleven application errors (5% of 217 visits) occurred early and were corrected. There were no adverse events requiring hospitalization. Patient satisfaction remained high. Conclusions: In this pilot, CHWs supported by an mHealth CDS application safely and effectively managed hypertension with high physician agreement, patient retention, and blood pressure improvement. These findings demonstrate the feasibility of CHW task-sharing hypertension management in low-resource settings and support evaluation of this approach in larger trials.
No takes yet. Share an insight, caveat, or question.
Duffy et al. (2026) studied Hypertension (n=32). mHealth clinical decision support (CDS) application was evaluated on prescribing agreement between CHWs and supervising physicians with application antihypertensive recommendations. A community health worker-led hypertension management program using an mHealth clinical decision support application achieved 96.7% physician agreement and reduced median systolic blood pressure by 7.5 mmHg.
Synapse has enriched 10 related papers. Consider them for comparative context: