Hypertension Research Programme - HT07

A smartphone-based clinical decision support system for primary health

Project location: India

Project duration: 2012 - 2015

Funding organisation

• National Health and Medical Research Council (NHMRC)

Primary research aim

To test whether an electronic clinical decision support system will assist non-physician health workers and doctors in making evidence-based management decisions to lower their patients’ CVD risks.

Research objectives and methodology

The two specific objectives of this project are:

• To develop a multifaceted primary healthcare worker intervention that utilises a mobile device-based clinical decision support system to improve optimal BP control in high risk individuals.
• To evaluate this program utilising a mixed methods evaluation in a cluster randomised trial involving 54 villages in rural Andhra Pradesh.

The intervention is being evaluated using a stepped- wedge cluster randomised, controlled trial (cRCT) of two years duration.

Current status

• Development of the overall intervention with final refinements complete.
• Baseline complete household data collection conducted by trained interviewers in all 54 villages. Around 62,000 individuals aged 40 years and above interviewed. Almost 12,000 subjects detected to be at high CVD risk.
• Randomisation of the PHCs for intervention over 3 time intervals complete.
• Study is in the first six months of control phase.
• The first set of 6 PHC's started receiving intervention from early December 2014.

Project contact: Dr D Praveen - dpraveen [at] georgeinstitute.org.in

Investigators

• The George Institute for Global Health (Australia) - Dr David Peiris, Prof Anushka Patel, Prof Stephen Macmahon, Dr Rohina Joshi, Dr Stephen Jan, Dr Stephane Heritier
• Initiative for Cardiovascular Health Research in the Developing Countries and Centre for Chronic Disease Control (India) - Prof Dorairaj Prabhakaran
• University of Oxford (UK) - Dr Gari Clifford
• The George Institute for Global Health (India) - Dr Pallab Maulik

Publications

1. Raghu, A., Praveen, D., Peiris, D., Tarassenko, L., & Clifford, G. (2015). Engineering a mobile health tool for resource-poor settings to assess and manage cardiovascular disease risk: SMARThealth study. BMC Medical Informatics and Decision Making, 15(1), 1-15. doi:10.1186/s12911-015-0148-4
2. Raghu A, Praveen D, Peiris D, Tarassenko L, Clifford G. Implications of Cardiovascular Disease Risk Assessment Using the WHO/ISH Risk Prediction Charts in Rural India. PLoS One. 2015 Aug 19;10(8):e0133618. doi: 10.1371/journal.pone.0133618. eCollection 2015.
3. Praveen D, Patel A, Raghu A, Clifford GD, Maulik PK, Mohammad Abdul A et al.SMARTHealth India: Development and Field Evaluation of a Mobile Clinical Decision Support System for Cardiovascular Diseases in Rural India. JMIR mHealth and uHealth. 2014;2(4):e54.
4. Peiris D, Praveen D, Johnson C, Mogulluru K. Use of mHealth Systems and Tools for Non-Communicable Diseases in Low- and Middle-Income Countries: a Systematic Review. Journal of cardiovascular translational research. 2014; 7(8): 677-91.
5. Praveen D, Patel A, McMahon S, Prabhakaran D, Clifford GD, Maulik PK, et al. A multifaceted strategy using mobile technology to assist rural primary healthcare doctors and frontline health workers in cardiovascular disease risk management: protocol for the SMARTHealth India cluster randomised controlled trial. Implement Sci. 2013; 8: 137

Links

Technology to the service of a healthy heart - Media Release: 29/09/2016