Active Detection and Decentralized Dynamic Registry to Improve Uptake of Rheumatic Heart Disease Secondary Prevention
Description
There are four data files associated with this record: (1) ADD-RHD Prophylaxis Data - these data contain the Record ID, sex, educational level, RHD category at diagnosis, age, age of diagnosis, duration of antibiotic prophylaxis, and a percentage adherence to prophylaxis (continuous, each injection counts as 28 days of coverage, days of coverage/days of prescription), pre- and post-decentalization. (2) ADD-RHD Implementation Data - Three tabs on this spreadsheet contain raw time-motion data for providers giving RHD care, health system costing data (in UgX, exchange rate of 3700 to 1USD at time of analysis), and the results of facility surveys. (3) ADD-RHD Summary TMS - contains summary data of time motion surveys conducted (4) ADD-RHD Patient Costs Post-Decentralization - contains patient-level costs post-decentralization in USD.
Files
Steps to reproduce
A hybrid implementation-effectiveness study type III was designed to evaluate the effectiveness of a package of implementation strategies including a digital, cloud-based application to support decentralised RHD care, integrated into the public healthcare system in Uganda. Our overarching hypothesis was that secondary prophylaxis adherence could be maintained or improved via a decentralization strategy, compared with the centralised delivery strategy, by increasing retention in care. To evaluate this, eligible patients with RHD irrespective of their age enrolled at Lira and Gulu hospital registry sites will be consented for decentralized care at their nearest participating health centre. The primary outcome was adherence to secondary prophylaxis while detailed implementation measures were also collected to understand barriers and facilitators to decentralisation, digital application tool adoption and ultimately its use and scale-up in the public healthcare system.
Institutions
- Cincinnati Children's Hospital Heart Institute
- Uganda Heart Institute Ltd
- University of Washington