Skip to main content

Main menu

  • HOME
  • LATEST ARTICLES
  • ALL ISSUES
  • AUTHORS & REVIEWERS
  • RESOURCES
    • About BJGP Open
    • BJGP Open accessibility statement
    • Editorial Board
    • Editorial fellowships
    • Audio abstracts
    • eLetters
    • Alerts
    • Outreach
    • Feedback
    • BJGP Life
    • Advertising
    • Research into Publication Science
    • Conference
  • SPECIAL ISSUES
    • Special issue: Telehealth
    • Special issue: Race and Racism in Primary Care
    • Special issue: COVID-19 and Primary Care
    • Past research calls
  • RCGP
    • British Journal of General Practice
    • BJGP for RCGP members
    • RCGP eLearning
    • InnovAIT Journal
    • Jobs and careers

User menu

  • Alerts

Search

  • Advanced search
Intended for Healthcare Professionals
BJGP Open
  • RCGP
    • British Journal of General Practice
    • BJGP for RCGP members
    • RCGP eLearning
    • InnovAIT Journal
    • Jobs and careers
  • Subscriptions
  • Alerts
  • Log in
  • Follow bjgp on Twitter
  • Visit bjgp on Facebook
  • Blog
Intended for Healthcare Professionals
BJGP Open

Advanced Search

  • HOME
  • LATEST ARTICLES
  • ALL ISSUES
  • AUTHORS & REVIEWERS
  • RESOURCES
    • About BJGP Open
    • BJGP Open accessibility statement
    • Editorial Board
    • Editorial fellowships
    • Audio abstracts
    • eLetters
    • Alerts
    • Outreach
    • Feedback
    • BJGP Life
    • Advertising
    • Research into Publication Science
    • Conference
  • SPECIAL ISSUES
    • Special issue: Telehealth
    • Special issue: Race and Racism in Primary Care
    • Special issue: COVID-19 and Primary Care
    • Past research calls
Research

Enhanced hypertension care through private clinics in Pakistan: a cluster randomised trial

Muhammad Amir Khan, Nida Khan, John D Walley, Shaheer Ellahi Khan, Joseph Hicks, Faisal Imtiaz Sheikh, Muhammad Ahmar Khan, Muhammad Ali, Maqsood Ahmed, Haroon Jehangir Khan and Rony Zachariah
BJGP Open 2019; 3 (1): bjgpopen18X101617. DOI: https://doi.org/10.3399/bjgpopen18X101617
Muhammad Amir Khan
1Chief Coordinating Professional, Association for Social Development, , Pakistan
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Nida Khan
2Project Coordinator, Association for Social Development, , Pakistan
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: nidakhan@asd.com.pk
John D Walley
3Professor of International Public Health, Nuffield Centre for International Health and Development, Leeds Institute of Health Sciences, University of Leeds, , UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Shaheer Ellahi Khan
4Assistant Professor, Humanities and Social Sciences Department, Bahria University, , Pakistan
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Joseph Hicks
5Senior Medical Statistician, Nuffield Centre for International Health and Development, Leeds Institute of Health Sciences, , UK
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Faisal Imtiaz Sheikh
6Research Coordinator, Association for Social Development, , Pakistan
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Muhammad Ahmar Khan
7Research Coordinator, Association for Social Development, , Pakistan
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Muhammad Ali
8Research Assistant, Association for Social Development, , Pakistan
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Maqsood Ahmed
9Senior Professional, Association for Social Development, , Pakistan
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Haroon Jehangir Khan
10Director, NCD & Mental Health, Directorate General of Health Services, , Pakistan
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Rony Zachariah
11General Coordinator and Strategic Advisor, Operational Research, Médecins Sans Frontières, , Belgium
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info
  • eLetters
  • PDF
Loading

Article Figures & Data

Figures

  • Tables
  • Figure 1.
    • Download figure
    • Open in new tab
    • Download powerpoint
    Figure 1. CONSORT trial flow chart

Tables

  • Figures
    • View popup
    Table 1. Baseline characteristics
    CharacteristicsIntervention, n (%)Control, n (%)
    Clusters
    Total13 (50.0)13 (50.0)
    Doctors
    Male13 (100.0)13 (100.0)
    Female0 (0.0)0 (0.0)
    Paramedics
    Male13 (100.0)13 (100.0)
    Female0 (0.0)0 (0.0)
    Participants
    Total574 (50.4)564 (49.6)
    Mean cluster size (SD)44.15 (33.22)43.38 (27.96)
    Sex
    Male290 (50.5)268 (47.5)
    Female284 (49.5)296 (52.5)
    Mean age, years (SD)45.69 (11.72)44.60 (12.40)
    Mean education, years (SD)6.5 (4.8)6.1 (4.4)
    Mean BMI, kg/m2 (SD)27.52 (5.85)26.49 (5.67)
    Hypertensive574 (100)564 (100)
    Smoker71 (12.4)90 (16.0)
    Mean fasting blood sugar, mg/dL (SD)134.69 (56.06)141.88 (55.81)
    Mean random blood sugar, mg/dL (SD)151.99 (70.73)140.78 (62.43)
    Mean HbA1c (%)8.28 (2.51)8.026 (2.58)
    Mean systolic blood pressure, mmHg (SD)161.25 (13.28)161.42 (16.38)
    Mean diastolic blood pressure, mmHg (SD)103.60 (8.91)103.48 (9.02)
    Mean serum cholesterol, mg/dL (SD)195.06 (45.38)185.95 (44.03)
    • Hypertensive defined as baseline SBP >140 mmHg.

    • View popup
    Table 2. Primary and secondary outcomes
    Intervention, 
    mean outcome (95% CI)
    (clusters n = 13)
    Control, 
    mean outcome (95% CI)
    (clusters n = 13)
    Crude control-intervention difference (95% CI); P valuebAdjusted control-intervention difference (95% CI); P valueb
    Change in SBP, mmHgc-25.23 
    (-29.86 to -20.61)
    -9.41 
    (-21.24 to 2.24)
    15.82 
    (3.60 to 28.04); 0.01
    12.63 (0.68 to 24.57); 0.04
    Change in DBP, mmHgc-18.18 
    (-22.12 to -14.25)
    -8.62 
    (-15.00 to -2.24)
    9.57 
    (2.39 to 16.74); 0.01
    7.58 
    (0.61 to 14.55); 0.04
    Hypertension control, %d69.56 
    (57.09 to 82.03)
    35.79 
    (15.44 to 56.13)
    -34pp 
    (-56 to -11); 0.01
    -30pp
    (-53 to -6); 0.02
    Change in HbA1c, %c-0.70pp 
    (-2.02 to 0.61)
    -1.71pp 
    (-2.63 to -0.79)
    1.01pp 
    (-2.53 to 0.52); 0.18
    0.59pp 
    (-0.29 to 0.17); 0.60
    Glycaemic control, %e33.03 
    (10.11 to 55.94%)
    42.79 
    (27.22 to 58.36%)
    10pp 
    (-17 to 36); 0.45
    3pp 
    (-2 to 87); 0.19
    Change in total serum cholesterol (mg/dL)c-27.69 
    (-31.69 to -23.69)
    0.52 
    (-9.85 to 10.89)
    28.21 
    (17.37 to 39.06); 0.001
    22.52 
    (15.89 to 29.16); 0.001
    Treatment adherencef73.11 
    (56.34 to 89.88)
    18.60 
    (6.63 to 30.57)
    -54.51 
    (-74.13 to -34.88); 0. 00
    -53.57 
    (-77.68 to -29.46); 0.00
    Smoking cessation3.08 
    (0.78 to 5.38)
    4.17 
    (1.74 to 6.62)
    1.10 
    (-2.08 to 4.28); 0.48
    0.03 
    (-1.37 to 1.43); 0.97
    • DBP = diastolic blood pressure. pp = percentage points. SBP = systolic blood pressure. aArm-specific mean outcomes and their 95% confidence intervals are themselves based on cluster-level summary (mean/proportion) outcomes. bAll control minus intervention differences (that is, intervention effect estimates) are based on analysis of crude/covariate-adjusted cluster-level summary (mean/proportion) outcomes. cAll change outcomes are calculated as outcome at endpoint minus outcome at baseline. dHypertension control defined as endpoint systolic BP ≤140 mmHg; eGlycaemic control defined as endpoint HbA1c ≤7%. fTreatment adherence was defined as patient having attended ≥5 treatment visits. All differences for percentage outcomes are on the absolute scale as percentage points. All analyses use only complete cases.

    • View popup
    Table 3. Effect modification by sex for the primary outcome (change in SBP)
    Mean outcome (95% CI)a
    Intervention
    (clusters n = 13)
    Control 
    (clusters n = 13)
    Crude effect (95% CI); P valuebAdjusted effect (95% CI); P value
    Female change in SBP-25.62
    (-30.49
     to -20.75)
    -10.42
    (-21.92 to 1.09)
    15.20
    (3.06 to 27.34); 0.02
    13.32
    (0.74 to 25.89); 0.04
    Male change in SBP-24.64
    (-29.33
     to -19.95)
    -7.52
    (-23.42 to 8.39)
    17.13
    (0.81 to 33.44); 0.04
    17.51
    (3.69 to 31.34); 0.02
    Female–male
    difference
    for change in SBP
    ---1.93
    (-12.38 to 8.53); 0.70
    -0.50
    (-9.27 to 8.27); 0.90
    • SBP = systolic blood pressure. aArm-specific mean outcomes and their 95% confidence intervals are themselves based on cluster-level summary mean outcomes for females/males/female–male differences. bAll control minus intervention differences (intervention effect estimates) are based on analysis of crude/covariate-adjusted cluster-level summary (mean/proportion) female–male difference outcomes. Change in SBP is calculated as outcome at endpoint minus outcome at baseline.

Back to top
Previous ArticleNext Article

In this issue

BJGP Open
Vol. 3, Issue 1
April 2019
  • Table of Contents
  • Index by author
Download PDF
Download PowerPoint
Article Alerts
Or,
sign in or create an account with your email address
Email Article

Thank you for recommending BJGP Open.

NOTE: We only request your email address so that the person to whom you are recommending the page knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Enhanced hypertension care through private clinics in Pakistan: a cluster randomised trial
(Your Name) has forwarded a page to you from BJGP Open
(Your Name) thought you would like to see this page from BJGP Open.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Enhanced hypertension care through private clinics in Pakistan: a cluster randomised trial
Muhammad Amir Khan, Nida Khan, John D Walley, Shaheer Ellahi Khan, Joseph Hicks, Faisal Imtiaz Sheikh, Muhammad Ahmar Khan, Muhammad Ali, Maqsood Ahmed, Haroon Jehangir Khan, Rony Zachariah
BJGP Open 2019; 3 (1): bjgpopen18X101617. DOI: 10.3399/bjgpopen18X101617

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Enhanced hypertension care through private clinics in Pakistan: a cluster randomised trial
Muhammad Amir Khan, Nida Khan, John D Walley, Shaheer Ellahi Khan, Joseph Hicks, Faisal Imtiaz Sheikh, Muhammad Ahmar Khan, Muhammad Ali, Maqsood Ahmed, Haroon Jehangir Khan, Rony Zachariah
BJGP Open 2019; 3 (1): bjgpopen18X101617. DOI: 10.3399/bjgpopen18X101617
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One
  • Mendeley logo Mendeley

Jump to section

  • Top
  • Article
    • Abstract
    • How this fits in
    • Introduction
    • Method
    • Results
    • Discussion
    • Funding
    • Ethical approval
    • Provenance
    • Acknowledgements
    • Trial registration
    • Notes
    • References
  • Figures & Data
  • Info
  • eLetters
  • PDF

Keywords

  • Cluster randomised controlled trial
  • primary private clinics
  • hypertension
  • contextualised care package
  • primary care
  • General practice

More in this TOC Section

  • An evaluation of a student led career profiling project to support the exploration of a career in general practice and other specialties.
  • How do UK general practice staff understand and manage prediabetes? A focus group study
  • Study of the sensitivity and specificity of smell and taste disorders as a predictive factor of SARS-CoV-2 infection among primary care healthcare professionals: a retrospective observational study
Show more Research

Related Articles

Cited By...

Intended for Healthcare Professionals

@BJGPOpen's Likes on Twitter

 
 

British Journal of General Practice

NAVIGATE

  • Home
  • Latest articles
  • Authors & reviewers
  • Accessibility statement

RCGP

  • British Journal of General Practice
  • BJGP for RCGP members
  • RCGP eLearning
  • InnovAiT Journal
  • Jobs and careers

MY ACCOUNT

  • RCGP members' login
  • Terms and conditions

NEWS AND UPDATES

  • About BJGP Open
  • Alerts
  • RSS feeds
  • Facebook
  • Twitter

AUTHORS & REVIEWERS

  • Submit an article
  • Writing for BJGP Open: research
  • Writing for BJGP Open: practice & policy
  • BJGP Open editorial process & policies
  • BJGP Open ethical guidelines
  • Peer review for BJGP Open

CUSTOMER SERVICES

  • Advertising
  • Open access licence

CONTRIBUTE

  • BJGP Life
  • eLetters
  • Feedback

CONTACT US

BJGP Open Journal Office
RCGP
30 Euston Square
London NW1 2FB
Tel: +44 (0)20 3188 7400
Email: bjgpopen@rcgp.org.uk

BJGP Open is an editorially-independent publication of the Royal College of General Practitioners

© 2022 BJGP Open

Online ISSN: 2398-3795