2024
Multilevel determinants of antiretroviral therapy initiation and retention in the test-and-treat era of Nepal: a qualitative study
Shrestha A, Poudel L, Shrestha S, Jha N, Kuikel B, Shakya P, Kunwar R, Pandey L, KC M, Wilson E, Deuba K. Multilevel determinants of antiretroviral therapy initiation and retention in the test-and-treat era of Nepal: a qualitative study. BMC Health Services Research 2024, 24: 927. PMID: 39138448, PMCID: PMC11323673, DOI: 10.1186/s12913-024-11311-6.Peer-Reviewed Original ResearchConceptsAntiretroviral therapy initiationHealthcare providersDenial of HIV statusPerspectives of healthcare providersAntiretroviral therapyCommunity health workersStrengthening healthcare systemsART initiationHealth system levelLong-term health outcomesHealthcare system levelAntiretroviral therapy clientsChanging public health policyFear of disclosureIndividual-level facilitatorsSocio-ecological modelImplementing antiretroviral therapyAvailability of medicationsPublic health policiesAntiretroviral therapy adherencePerceived health benefitsFear of deathClient tracking systemProvision of free treatmentHealth workersImpact of a community health worker led intervention for improved blood pressure control in urban Nepal: an open-label cluster randomised controlled trial
Bhattarai S, Skovlund E, Shrestha A, Mjølstad B, Åsvold B, Sen A. Impact of a community health worker led intervention for improved blood pressure control in urban Nepal: an open-label cluster randomised controlled trial. The Lancet Regional Health - Southeast Asia 2024, 29: 100461. PMID: 39220804, PMCID: PMC11364134, DOI: 10.1016/j.lansea.2024.100461.Peer-Reviewed Original ResearchCommunity health workersIntervention arm compared to controlsWaist-to-hip ratioHealth workersRandomised controlled trialsBody mass indexPhysical activityDaily salt intakeHealthcare providersSystolic blood pressureDiastolic blood pressureCluster randomised controlled trialOpen-label cluster randomised controlled trialRoutine follow-up careMass indexHealth system barriersAdequate physical activityControlled trialsTrained healthcare providersDiet quality scoresBlood pressure controlPublic health facilitiesInterventions targeting individualsUrban NepalControl blood pressure
2023
Facilitators and barriers to hypertension management in urban Nepal: findings from a qualitative study
Bhattarai S, Bajracharya S, Shrestha A, Skovlund E, Åsvold B, Mjolstad B, Sen A. Facilitators and barriers to hypertension management in urban Nepal: findings from a qualitative study. Open Heart 2023, 10: e002394. PMID: 37899127, PMCID: PMC10618998, DOI: 10.1136/openhrt-2023-002394.Peer-Reviewed Original ResearchConceptsPrimary healthcare providersHypertension servicesHypertension managementHealthcare providersHypertension patientsHome visitsSocioecological modelCommunity-level barriersUrban NepalFocus group discussionsTreatment measuresControl of hypertensionGender normsHigh blood pressureCommunity health workersMunicipal officialsAspects of careFamily membersDepth interviewsQualitative methodologyPrimary healthcare systemCommunity trustLow-resource countriesQualitative studyAntihypertensive medications
2020
An integrated intervention for chronic care management in rural Nepal: protocol of a type 2 hybrid effectiveness-implementation study
Schwarz D, Dhungana S, Kumar A, Acharya B, Agrawal P, Aryal A, Baum A, Choudhury N, Citrin D, Dangal B, Dhimal M, Gauchan B, Gupta T, Halliday S, Karmacharya B, Kishore S, Koirala B, Kshatriya U, Levine E, Maru S, Rimal P, Sapkota S, Schwarz R, Shrestha A, Thapa A, Maru D. An integrated intervention for chronic care management in rural Nepal: protocol of a type 2 hybrid effectiveness-implementation study. Trials 2020, 21: 119. PMID: 31996250, PMCID: PMC6990567, DOI: 10.1186/s13063-020-4063-3.Peer-Reviewed Original ResearchMeSH KeywordsAlcohol DrinkingAllied Health PersonnelChronic DiseaseCommunity Health WorkersDecision Support Systems, ClinicalDisease ManagementHumansImplementation ScienceMedication AdherenceMotivational InterviewingNepalNoncommunicable DiseasesRisk Reduction BehaviorRural PopulationTobacco Use CessationConceptsHybrid effectiveness-implementation studyEffectiveness-implementation studyChronic care managementMid-level practitionersCare management interventionCommunity health workersCare managementMiddle-income countriesHealth workersChronic care management programWorld Health Organization PackageRisk factor optimizationClinical decision support toolEvidence-based careCare management programPrimary care systemRural NepalTobacco consumption levelsEvidence-based componentsMultiple comorbiditiesSecondary outcomesUniversal health coveragePrimary outcomeMedication adherencePre-post design