The ADHINCRA Study: Addressing HypertensIoN Care in AfRicA

Project Summary/Abstract Innovation in chronic disease management is urgently needed to effectively control hypertension (HTN) in Ghana and Nigeria. Both countries are suffering silent epidemics of chronic diseases with rates closely resembling those of high-income countries. Uncontrolled HTN causes cardiovascular disease, stroke, chronic

kidney disease, and premature death. However, HTN is poorly controlled in both countries due to patient-, provider, and system-level barriers. A pressing global health challenge is implementing evidence-based and contextually appropriate strategies to improve chronic disease management in Ghana and Nigeria. Multilevel

interventions improve HTN control. For instance, team-based care, a health systems-level and organizational intervention, improves the quality of HTN care. Telehealth can be enhanced with home blood pressure monitoring (HBPM) to address patient-, and provider-level barriers. The COVID-19 pandemic has spurred

efforts to increase access to timely and appropriate care through re-engineering primary care to be patient- centered and digitally enabled. Sphygmo Home, a remote telemonitoring app that links with validated blood pressure (BP) and glucose monitoring devices, is a promising solution to improve patients’ self-management of

chronic disease. In a previous pilot study, we investigated the impact of a multilevel and digitally-enabled home- based intervention compared to enhanced usual care (UC). After 12 months, 80.5% in the intervention arm, compared to 24.2% in the enhanced UC arm, had controlled BP (p