Diabetes Clinical Trial
Official title:
A Prospective Randomised Trial Comparing Three Interventions to Improve Treatment Adherence Among Patients With Arterial Hypertension or Diabetes in Rural Cameroon (TAHADIRA-trial 1)
The purpose of this study is to determine the efficacy of three different interventions to improve treatment adherence among patients with arterial hypertension or diabetes in rural Cameroon.
Non communicable chronic diseases such as arterial hypertension (AH) and diabetes (DM) are a
great burden for public health in Cameroon. However, outside the main cities access to
appropriate diagnosis and treatment of these health-conditions is still very poor.
The Swiss NGO "Fondation Coopération Afrique" started in 2007 a program to integrate chronic
disease management with focus on AH and DM into the primary health care system of peripheral
non-physician health facilities in a rural area of Central Cameroon. A first evaluation
after one year revealed very low treatment adherence among the newly diagnosed patients as
the main challenge.
In order to improve patient's adherence we expose them randomly to one of three
interventions:
The first intervention consists in a written agreement on long-lasting therapy (treatment
contract). Patients get information about the importance of a regular long term treatment
and personal engagement to follow treatment and clinical controls regularly.
The second intervention introduces in addition to the treatment contract a reminder system.
In case of follow-up failure a community worker traces the patient to recall the visit at
the health centre.
The third intervention consists of the treatment contract combined with a financial
incentive in form of one month free treatment after four months of regular follow-up.
We allocated randomly one of the three interventions to each health center.
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Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Health Services Research
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