TETRA

Technology Enabled health workers to deliver Telemedicine to Rural Homes at Affordable costs

2,456

Individuals Screened

38.9% (HTN) | 28.6% (Diabetes)

New Cases Identified

54% Improved

Blood Pressure Control

Overview

‘TETRA’ uses a novel strategy anchored by non-physician health workers (NPHWs) equipped with a tablet computer with embedded decision prompt systems (mHealth tool) linked to point-of-care devices for blood pressure and blood sugar measurement and guided remotely by a physician via Skype, screen individuals for hypertension and diabetes, facilitate a telemedicine consult, print a physician ordered e-prescription and distribute medication at the doorsteps of beneficiaries across six villages in Telangana (India). The NPHWs follow-up individuals with hypertension and diabetes once in three months and provide a continuum of care.

Aim

To demonstrate feasibility, effectiveness and sustainability of a low-cost telemedicine strategy for detection, treatment and monitoring of blood pressure and blood sugar in remote and underserved locations.

Objectives

To demonstrate the feasibility, effectiveness, and sustainability of a low-cost telemedicine model for the detection, treatment, and longitudinal monitoring of blood pressure and blood sugar in remote and underserved rural settings.

Results

Eligible Individuals: 2456
Hypertension: Screened: 1751; Prevalence: 23.6%; Newly detected: 38.9 %
Diabetes: Screened: 1686; Prevalence: 11.2 %; Newly detected: 28.6 %

Clinical Improvement at 24 Months

Blood sugar control improved in 34.1 percent of 189 individuals, corresponding to 64 individuals
Blood pressure control improved in 54.0 percent of 414 individuals, corresponding to 224 individuals
Improvement in known hypertensives increased by 12 percent, with a 95 percent confidence interval of 7.9 to 16.0 percent

Conclusion

Our study demonstrates the feasibility, and local acceptability of implementing a mHealth and task-sharing intervention model for hypertension and diabetes detection and control in community settings in India. Our strategy holds promise to facilitate delivery of care on a continuum for hypertension and diabetes in resource poor settings.