Pilot and feasibility study of the Managing hypertension Among People living with HIV: an InTegrated model (MAP-IT) project

Abstract

People Living with HIV (PLWH) are at increased risk for non-communicable diseases (NCDs) including hypertension as the most common CVD risk factor. Integration of hypertension management into HIV care has been identified as an effective strategy, however limited data in the primary health care setting exist in Nigeria [1–5]. We assessed the feasibility of integrating task-shifting strategy for hypertension control (TASSH) in a pilot study of two primary health centers using practice facilitation as our implementation strategy. Two primary health care centers, not planned for inclusion in the larger trial, were recruited to participate in the pilot study. Persons living with HIV aged 18 years and older with elevated blood pressure (BP) between 140 and 179 mm Hg systolic or 90–109 mm Hg diastolic, were recruited. PF was provided by experienced and retired nurses with experience in the primary care setting. The feasibility of using fidelity tools to collect data on the implementation of TASSH and PF within the two pilot sites was tested. A majority of participants (83%) were female; 70% of participants had a previous diagnosis of hypertension. Although improvement in BP control was not observed following PF, systolic BP decreased by an average of 7.2 mm Hg (95% CI: 1.1, 13.3), as did diastolic blood pressure by 5.4 mm Hg pm average (95% CI: 1.8, 9.1) following PF initiation. Implementation fidelity tools capturing the ability of the community nurses and practice facilitators to implement TASSH and PF were found to be acceptable for both data collection and measurement. Feasibility of data collection was demonstrated, and some evidence of a reduction in systolic and diastolic BP by PF was observed. NCT05031819 first registered Sept 2, 2021. https://clinicaltrials.gov/study/NCT05031819 .