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Coaching and Navigation by Community Health Workers (CHWs) Through Telehealth for High-risk Hypertension

Sponsor: Weill Medical College of Cornell University • ClinicalTrials.gov ID: NCT07461415

Registry updated: 2026-09-17

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Description

The investigators propose an intervention that leverages the success of Community Healthcare Workers (CHWs) and telehealth to connect patients with severe hypertension from Emergency Department (ED) to primary care resources and to coach them to adopt evidence-based, practical lifestyle solutions relevant to urban living. The investigators have proposed this intervention as "Coaching and Navigation by Community Health Workers (CHWs) through Telehealth for High-risk Hypertension: CONNECT-HTN intervention. The investigators hypothesize that participants receiving the CONNECT-HTN intervention will have a lower likelihood of experiencing a major cardiac event compared with those referred to clinic-based care.

Interventions

CONNECT-HTN (Behavioral)
We propose a multimodal intervention that leverages the success of CHWs and telehealth to connect patients with severe hypertension to primary care resources and coach them to adopt evidence-based, practical lifestyle solutions relevant to urban living. We call the intervention Coaching and Navigation by CHW through Telehealth for High-risk Hypertension or CONNECT-HTN. CONNECT HTN will add to the evidential basis for implementing many of the WHO Best Buys for Non-Communicable Disease (NCD) prevention and control, and will be the first study powered to measure substantive mortality and mortality outcomes in LMICs.
Standard ED management (Other)
During the Emergency Department (ED) admission, the participants in the control group will be provided a blood pressure measurement device and training to calculate their blood pressure at home. Standard ED management will be provided to these patients, followed by either discharge or admission for the management of hypertension.

Eligibility criteria

Inclusion Criteria: Eligible patients * Must be over the age of 18 years * Have an ED triage SBP ≥ 180 and/or DBP ≥ 110, with a repeat similar reading ≥30 minutes after triage * May have received treatment for elevated BP, but must have no evidence of end-organ damage (defined as dialysis dependence, acute stroke, acute coronary syndrome, acute kidney injury, or papilledema) * Have a functional status of either fully active (independent in daily activities) or mildly restricted but ambulatory and able to work (washing, toileting, dressing, feeding, mobility). * May be admitted for deranged BP only with no complications, or may be stable for discharge per treating emergency physician * Include referrals from the clinic to the ED with SBP/DBP values in the inclusion range * Can provide informed consent. Intervention is accessible to individuals of all literacy levels * Can receive phone calls and in-person visits. Smartphone ownership not required (intervention compatible with analog phones) Exclusion Criteria: Given that hypertension is defined and treated differently, we will exclude * pregnant patients * terminally ill patients, as well as * those requiring admission to the hospital due to severe complications (other than deranged BP).

Conditions

Hypertension

Locations

Aga Khan University Hospital (AKUH) — Karachi, Sindh, Pakistan
Dow University Hospital, Ojha Campus — Karachi, Sindh, Pakistan
Jinnah Postgraduate Medical Center (JPMC) — Karachi, Pakistan
Kharadar General Hospital (KGH) — Karachi, Pakistan
Sindh Institute of Emergency and Health Sciences (SIEHS) — Karachi, Pakistan

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Official Source

Data sourced from ClinicalTrials.gov, a service of the U.S. National Institutes of Health.

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