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August 16, 2017PLoS ONEOpen Access

Implementation of a comprehensive intervention for patients at high risk of cardiovascular disease in rural China: A pragmatic cluster randomized controlled trial

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Why the study?

Does a comprehensive primary care intervention package improve medication prescribing, adherence, and blood pressure in high-risk cardiovascular patients in rural China?

Population

28,130 adults aged 50-74 years with hypertension and a 10-year cardiovascular disease risk score >20% or…

Comparison

Comprehensive intervention package delivered by… vs Usual care.

Design

RCT, Randomly allocated eligible township hospitals to intervention or control…

Follow-up

12 months

Authors

XWXiaolin WeiJWJohn WalleyZZZhitong Zhang

Discussion

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Member takes

Overview

Supports integrating case management into rural primary care to boost prescribing; confirms feasibility but leaves open effects on BP and biomarkers.

Structured PICO

Does a comprehensive primary care intervention package improve medication prescribing, adherence, and blood pressure in high-risk cardiovascular patients in rural China?

P
Population
28,130 adults aged 50-74 years with hypertension and a 10-year cardiovascular disease risk score >20% or diabetes, excluding those with a history of severe CVD events, in rural China (Zhejiang province). Mean age 64.3 years, 48.9% male.
I
Intervention
Comprehensive intervention package delivered by family doctors, including prescription of a standardized package of medicines (anti-hypertensives, statins, and low-dose aspirin), specific lifestyle advice, and medication adherence support over 12 months.
C
Comparator
Usual care (conventional clinical consultations with treatment provided according to the individual family doctor's existing knowledge and discretion).
O
Outcome
Rates of prescribing and actual drug-taking of recommended highly effective medicines, and mean systolic and diastolic blood pressure at 12 months.surrogate

A comprehensive primary care intervention in rural China significantly improved the prescribing and adherence of evidence-based cardiovascular medications, though it did not significantly reduce blood pressure at 12 months.

Cite This Study

Wei et al. (2017) studied this question.

synapsesocial.com/papers/6a6fca6bf44fa9f079dd47a3https://doi.org/10.1371/journal.pone.0183169
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Evaluation of a systematic cardiovascular disease risk reduction strategy in primary healthcare: an exploratory study from Zhejiang, China2014 · 15 citations
  2. 2A Cluster-Randomized, Controlled Trial of a Simplified Multifaceted Management Program for Individuals at High Cardiovascular Risk (SimCard Trial) in Rural Tibet, China, and Haryana, India2015 · 183 citations
  3. 3Use of Medications and Lifestyles of Hypertensive Patients with High Risk of Cardiovascular Disease in Rural China2015 · 20 citations
  4. 4Characteristics of High Risk People with Cardiovascular Disease in Chinese Rural Areas: Clinical Indictors, Disease Patterns and Drug Treatment2013 · 16 citations
  5. 5Multiple risk factor interventions for primary prevention of cardiovascular disease in low- and middle-income countries2015 · 95 citations