Abstract 214: Non-Health Professional Interventions For Hypertension: Systematic Review Comparing Interventions Leveraged In Developed And Developing Economies

Background: Non-health professionals, most often in the form of community health workers, have been deployed in both developed and developing economies to improve hypertension outcomes. Variation between developed and developing economies in the type and outcome of these interventions is unknown. Aim: Compare the deployment and efficacy of non-health professional interventions targeting hypertension in developed and developing economies. Methods: Several databases including Medline were systematically searched until December 2020. All study designs with non-health professional interventions for hypertension were included. Eligible articles were coded by two independent reviewers. Results: Of the 23 articles eligible for inclusion, 15 studies (65%) were from developed economies and 8 (35%) from developing economies. Non-health professional recruitment, selection and intervention durations were similar in developed and developing economies. Positive hypertension and health service utilization outcomes were seen in most studies. Interventions in developed economies: Only 33% (5 of 15) of the studies included some form of home visits, while 60% (9 of 15) of interventions focused on group education. Phone calls were incorporated into 47% (7 of 15) of the studies to further promote medication adherence, appointment keeping, or to discuss progress. Interventions in developing economies: Home visits were part of 75% (6 of 8) of the studies and only 25% (2 of 8) focused on group education. A single study of the 8 (13%) included phone calls for appointment reminders and was the sole study that was clinic, not community based, and did not report positive outcomes. One study also included one-way outgoing text messages to promote lifestyle changes and medication adherence. Conclusions: Developed and developing economies diverge in the type of non-health professional intervention employed. Studies from developed economies mainly include group education with phone calls for individualization, whereas studies in developing economies prioritized home visits. Most studies resulted in positive outcomes suggesting that various forms of non-health professional support are effective for improving hypertension outcomes in diverse settings.