Browsing by Author "Nikhil Tandon"

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    A cluster randomized controlled trial of an electronic decision-support system to enhance antenatal care services in pregnancy at primary healthcare level in Telangana, India: trial protocol
    (BMC Pregnancy Childbirth, 2023) Sailesh Mohan; Monica Chaudhry; Ona McCarthy; Prashant Jarhyan; Clara Calvert; Devraj Jindal; Rajani Shakya; Emma Radovich; Dimple Kondal; Loveday Penn-Kekana; Kalpana Basany; Ambuj Roy; Nikhil Tandon; Abha Shrestha; Abha Shrestha; Biraj Karmacharya; John Cairns; Pablo Perel; Oona M. R. Campbell; Dorairaj Prabhakaran
    Background India contributes 15% of the total global maternal mortality burden. Lessons learned from this trial will also inform recommendations for designing and upscaling similar mHealth interventions in other low and middle-income countries.
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    A cluster-randomized controlled trial to evaluate the effects of a simplified cardiovascular management program in Tibet, China and Haryana, India: study design and rationale
    (BMC Public Health, 2014) Vamadevan S. Ajay; Maoyi Tian; Hao Chen; Yangfeng Wu; Xian Li; Danzeng Dunzhu; Mohammed K. Ali; Nikhil Tandon; Anand Krishnan; Dorairaj Prabhakaran; Lijing L. Yan
    Background: In resource-poor areas of China and India, the cardiovascular disease burden is high, but availability of and access to quality healthcare is limited. Establishing a management scheme that utilizes the local infrastructure and builds healthcare capacity is essential for cardiovascular disease prevention and management. The study aims to develop, implement, and evaluate the feasibility and effectiveness of a simplified, evidence-based cardiovascular management program delivered by community healthcare workers in resource-constrained areas in Tibet, China and Haryana, India. Methods/design: This yearlong cluster-randomized controlled trial will be conducted in 20 villages in Tibet and 20 villages in Haryana. Randomization of villages to usual care or intervention will be stratified by country. High cardiovascular disease risk individuals (aged 40 years or older, history of heart disease, stroke, diabetes, or measured systolic blood pressure of 160 mmHg or higher) will be screened at baseline. Community health workers in the intervention villages will be trained to manage and follow up high-risk patients on a monthly basis following a simplified '2 + 2' intervention model involving two lifestyle recommendations and the appropriate prescription of two medications. A customized electronic decision support system based on the intervention strategy will be developed to assist the community health workers with patient management. Baseline and follow-up surveys will be conducted in a standardized fashion in all villages. The primary outcome will be the net difference between-group in the proportion of high-risk patients taking antihypertensive medication pre- and post-intervention. Secondary outcomes will include the proportion of patients taking aspirin and changes in blood pressure. Process and economic evaluations will also be conducted. Discussion: To our knowledge, this will be the first study to evaluate the effect of a simplified management program delivered by community health workers with the help of electronic decision support system on improving the health of high cardiovascular disease risk patients. If effective, this intervention strategy can serve as a model that can be implemented, where applicable, in rural China, India, and other resource-constrained areas.
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    Burden, patterns, and impact of multimorbidity in North India: findings from a rural population-based study
    (BMC Public Health, 2022) Priti Gupta; Shivani A. Patel; Hanspria Sharma; Prashant Jarhyan; Rakshit Sharma; Dorairaj Prabhakaran; Nikhil Tandon; Sailesh Mohan
    This study estimates the prevalence, socio-demographic determinants, common disease combinations, and health impact of multimorbidity among a young rural population.