Active Screening of Arterial Hypertension by Community Outreach Workers in the Cayenne Metropolitan Area to Reduce the Incidence of Cardiovascular Disease

NCT ID: NCT05814068

Last Updated: 2023-04-14

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

50000 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-05-01

Study Completion Date

2025-08-01

Brief Summary

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The main objective is to implement of a community-based primary care intervention against high blood pressure. We want to show that this intervention decreases the incidence of stroke in the community of agglomerations of the central coast of French Guiana, with a rapid effectiveness of about -30% at 2 years.

Detailed Description

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The hypothesis of the research is that, thanks to a strategy of early detection of hypertension based on "outreach" by community relays, it will be possible to increase the effectiveness of primary prevention among the precarious population (early treatment, access to healthcare, improvement of therapeutic follow-up, reduction of renunciations and interruptions of treatment). This strategy, adapted to the Guianese context, would make it possible to reduce the incidence and mortality of cardiovascular diseases among the most vulnerable people, particularly stroke. Such data would be a prerequisite for a more ambitious strategy, aiming to implement policies on a sufficient scale policies on a scale and intensity sufficient to have an impact on the problem of social inequalities in health other than those related to high blood pressure.

The quasi-experimental before-and-after methodology makes it possible to compare, on a population basis, a quantitative endpoint - in this case the number of strokes - between before and after the implementation of a public health intervention. For reasons of acceptance by the partners, statistical power, and potential bias, a before-and-after design seems more interesting.

It will be a pre-screening of hypertension, a possible referral for medical care or opening of health care rights and health education through hygienic and dietary advice and health prevention focused on hypertension.

Conditions

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High Blood Pressure

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Intervention

diagnosis and treatment of high blood pressure

Group Type EXPERIMENTAL

antihypertensive drug treatment

Intervention Type DRUG

Patients with hypertension will be treated for it by their physician

Interventions

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antihypertensive drug treatment

Patients with hypertension will be treated for it by their physician

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Adults of at least 18 years old
* Residents of the agglomeration community of the central coast of French Guiana.

Exclusion Criteria

* Person who has objected to participating in the study
* Person under guardianship or curatorship, persons under protective supervision
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Centre Hospitalier de Cayenne

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Mathieu NACHER, PhD

Role: PRINCIPAL_INVESTIGATOR

Centre Hospitalier de Cayenne

Central Contacts

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Mathieu NACHER, PhD

Role: CONTACT

+594594395385

Devi ROCHEMONT, PhD

Role: CONTACT

+594594395385

References

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Mackenbach JP. Can we reduce health inequalities? An analysis of the English strategy (1997-2010). J Epidemiol Community Health. 2011 Jul;65(7):568-75. doi: 10.1136/jech.2010.128280. Epub 2011 Apr 1.

Reference Type BACKGROUND
PMID: 21459930 (View on PubMed)

Mackenbach JP. Has the English strategy to reduce health inequalities failed? Soc Sci Med. 2010 Oct;71(7):1249-1253. doi: 10.1016/j.socscimed.2010.07.014. Epub 2010 Aug 3. No abstract available.

Reference Type BACKGROUND
PMID: 20736133 (View on PubMed)

NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants. Lancet. 2021 Sep 11;398(10304):957-980. doi: 10.1016/S0140-6736(21)01330-1. Epub 2021 Aug 24.

Reference Type BACKGROUND
PMID: 34450083 (View on PubMed)

Rochemont DR, Mimeau E, Misslin-Tritsch C, Papaix-Puech M, Delmas E, Bejot Y, DeToffol B, Fournel I, Nacher M. The epidemiology and management of stroke in French Guiana. BMC Neurol. 2020 Mar 24;20(1):109. doi: 10.1186/s12883-020-01650-2.

Reference Type BACKGROUND
PMID: 32209060 (View on PubMed)

Rochemont DR, Lemenager P, Franck Y, Farhasmane A, Sabbah N, Nacher M. The epidemiology of acute coronary syndromes in French Guiana. Ann Cardiol Angeiol (Paris). 2021 Feb;70(1):7-12. doi: 10.1016/j.ancard.2020.09.032. Epub 2020 Oct 14.

Reference Type BACKGROUND
PMID: 33067006 (View on PubMed)

Valmy L, Gontier B, Parriault MC, Van Melle A, Pavlovsky T, Basurko C, Grenier C, Douine M, Adenis A, Nacher M. Prevalence and predictive factors for renouncing medical care in poor populations of Cayenne, French Guiana. BMC Health Serv Res. 2016 Jan 28;16:34. doi: 10.1186/s12913-016-1284-y.

Reference Type BACKGROUND
PMID: 26822003 (View on PubMed)

Van Melle A, Cropet C, Parriault MC, Adriouch L, Lamaison H, Sasson F, Duplan H, Richard JB, Nacher M. Renouncing care in French Guiana: the national health barometer survey. BMC Health Serv Res. 2019 Feb 6;19(1):99. doi: 10.1186/s12913-019-3895-6.

Reference Type BACKGROUND
PMID: 30728033 (View on PubMed)

Hart JT. Commentary: Can health outputs of routine practice approach those of clinical trials? Int J Epidemiol. 2001 Dec;30(6):1263-7. doi: 10.1093/ije/30.6.1263. No abstract available.

Reference Type BACKGROUND
PMID: 11821324 (View on PubMed)

Addo J, Ayerbe L, Mohan KM, Crichton S, Sheldenkar A, Chen R, Wolfe CD, McKevitt C. Socioeconomic status and stroke: an updated review. Stroke. 2012 Apr;43(4):1186-91. doi: 10.1161/STROKEAHA.111.639732. Epub 2012 Feb 23.

Reference Type BACKGROUND
PMID: 22363052 (View on PubMed)

Related Links

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http://beh.santepubliquefrance.fr/beh/2020/2-3/2020_2-3_1.html

Article - Bulletin épidémiologique hebdomadaire n.d

http://doi.org/10.5114/jhi.2018.77646

Rochemont DR, Dueymes JM, Roura R, Meddeb M, Couchoud C, Nacher M. End stage renal disease as a symptom of health inequalities in French Guiana.

Other Identifiers

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DEPIPREC

Identifier Type: -

Identifier Source: org_study_id

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