New Delhi (ISJ) ? In a first-ever joint trial, Indian and Chinese medical researchers have developed a mobile application to provide low-cost cardiovascular disease (CVD) care. The simplified programme, known as SimCard, helps in management of CVD and appropriate medications.
The study was carried out by researchers from Public Health Foundation of India (PHFI), All India Institute of Medical Sciences (AIIMS) - in 47 villages of Haryana in India, and George Institute for Global health at Peking University - in Tibet in China. It enrolled 2086 individuals with high CVD risks, defined as over 40 years old with a self-reported history of CVD and a measured systolic blood pressure (SBP) over 160mmHg. Community health workers (CHWs) were trained and deployed to manage those individuals with the assistance of an Android smartphone app consisting of a guideline-based but simplified CVD management program.
A simplified ?2+2? intervention model consists of two medications (blood pressure lowering agents and aspirin) and two lifestyle modifications (smoking cessation and salt reduction). The model was based on international and national clinical guidelines for CVD management so that it can be easily implemented and incorporated into the existing local healthcare system as well. In both China and India, interventions were tailored to the local cultures and customs where possible. For example, Health educational materials on lifestyle in China and India were all provided in local languages with cultural-specific images.
The combined results demonstrated the effectiveness of the SimCard trial in increasing the adherence to anti-hypertensive medications, (a net-difference of 25.5%. between the control and Intervention groups). In separate country-specific analysis, the net increase in the proportion of high-risk individuals taking aspirin was higher in China (24.5%) than in India (9.8%), but both were highly significant. There was a significant net reduction in mean SBP in China (-4.1 mmHg, P=0.006) but a non-significant decline in India. Both countries had large net increases (>16%) in the proportion of high-risk patients receiving monthly follow-up. Surprisingly, the study did not find any changes in lifestyle from either country.
Despite the differences in the healthcare system, socio-economic environment and culture, China and India both faced similar challenges in prevention and control with a rising burden of CVD, large urban-rural health disparities, limited resources and capacity.
?People think chronic diseases are only problems for the rich, but we now know that hypertension is a big problem. It?s affecting every section of the population,? said Dr. Dorairaj Prabhakaran, Co-Investigator of the study in India and Vice President of PHFI. ?The study was the first dual-country trial of its kind worldwide and presented a good example for other collaborations between the developing countries in view of the huge synergy recognized and its inexpensiveness and sustainability.?
India has an estimated burden of 6.1 crore cases of heart diseases and it accounts for about one in every four deaths in India, as in 2008 and it is growing at 9.2% annually. A more worrying fact is that the incidence of CVD have gone up significantly in people between the age group of 25 and 69 to 24.8%.
Image courtesy: PHFI