{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T17:31:55Z","timestamp":1790962315786,"version":"4.1.0"},"reference-count":58,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2024,8,23]],"date-time":"2024-08-23T00:00:00Z","timestamp":1724371200000},"content-version":"unspecified","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Research, Technology Transfer and Community Engagement office of College of Medicine and Health Sciences of the University of Gondar","award":["R\/T\/T\/C\/Eng.\/327\/02\/2019"],"award-info":[{"award-number":["R\/T\/T\/C\/Eng.\/327\/02\/2019"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,7,31]]},"published-print":{"date-parts":[[2024,8]]},"abstract":"\n Objectives<\/jats:title>\n To evaluate effects of health extension workers-led home-based multicomponent intervention on blood pressure change in hypertensive patients in rural districts of northwest Ethiopia.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Two-arm cluster randomised controlled trial was conducted.<\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n Hypertensive patients\u2019 age \u226525 years were included. 20 clusters or kebeles with 456 participants were randomly assigned to the intervention group (10 clusters with 228 participants) and the control group (10 clusters with 228 participants).<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n Participants in the intervention kebeles received health extension workers-led home-based multicomponent interventions every other month for 40\u201360\u2009min for 9\u2009months.<\/jats:p>\n <\/jats:sec>\n \n Main outcome measures<\/jats:title>\n The primary outcomes were the differences in mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) changes from baseline between patients in the intervention and control groups. Intention-to-treat analysis was used for the primary analyses. Linear mixed effect model was used to evaluate the intervention\u2019s effect on change in mean SBP and DBP. Effect sizes of mean difference and relative benefit increase were used.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n At 9\u2009months, the mean SBP decreased by 15.8\u2009mm Hg (95%\u2009CI: 13.5, 18.1) in the intervention and 10.8\u2009mm Hg (95%\u2009CI: 8.7, 12.9) in the control groups; with a 5.0\u2009mm Hg (95%\u2009CI: 1.9, 8.1) greater reduction in the intervention group. The mean DBP decreased by 12.1\u2009mm Hg (95%\u2009CI: 10.6, 13.5) in the intervention and 8.4\u2009mm Hg (95%\u2009CI: 7.0, 9.8) in the control group. The proportion of optimal blood pressure control was higher in the intervention group (45.8%) than the control group (28.2%) with percentage difference of 17.6% (95% CI: 8.5, 26.7).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Health extension workers-led home-based multicomponent intervention has resulted significant reduction of blood pressure and achieved a higher proportion of optimal blood pressure control. This strategy is effective, but further research is needed to determine its cost effectiveness for scaling up and integrating in primary care settings.<\/jats:p>\n <\/jats:sec>\n \n Trial registration<\/jats:title>\n The trial is registered with Pan African clinical trial registry (PACTR202102729454417).<\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-084029","type":"journal-article","created":{"date-parts":[[2024,8,24]],"date-time":"2024-08-24T04:49:42Z","timestamp":1724474982000},"page":"e084029","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Effect of health extension workers-led home-based multicomponent intervention on blood pressure reduction among hypertensive patients in rural districts of northwest Ethiopia: a cluster-randomised controlled trial"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7129-8551","authenticated-orcid":false,"given":"Destaw Fetene","family":"Teshome","sequence":"first","affiliation":[{"name":"Epidemiology and Biostatistics, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shitaye","family":"Alemu","sequence":"additional","affiliation":[{"name":"Internal Medicine, University of Gondar, Gondar, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tadesse Awoke","family":"Ayele","sequence":"additional","affiliation":[{"name":"Epidemiology & Biostatistics, University of Gondar, Gondar, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5012-3098","authenticated-orcid":false,"given":"Asmamaw","family":"Atnafu","sequence":"additional","affiliation":[{"name":"Health System and policy, University of Gondar College of Medicine and Health Sciences, Gondar, Gondar, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kassahun Alemu","family":"Gelaye","sequence":"additional","affiliation":[{"name":"Epidemiology and Biostatistics, University of Gondar, Gondar, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,8,24]]},"reference":[{"key":"2025121511535728000_14.8.e084029.1","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1186\/s12939-021-01516-0","article-title":"The triple burden of communicable and non-communicable diseases and injuries on sex differences in life expectancy in Ethiopia","volume":"20","author":"Jung","year":"2021","journal-title":"Int J Equity Health"},{"key":"2025121511535728000_14.8.e084029.2","unstructured":"Kaba M . 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