Improving hypertension care in Ghana and Baltimore
Addressing Hypertension Care in Africa (ADHINCRA) Program
This program tests whether a package of patient-, provider-, and health-system interventions can improve blood pressure control for adults ages 18–70 with hypertension who receive care at participating clinics and own a smartphone.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 800 (estimated) |
| Ages | 18 Years to 70 Years |
| Sex | All |
| Sponsor | Johns Hopkins University Academic / other |
| Locations | 17 sites (Baltimore, Maryland and 16 other locations) |
| Trial ID | NCT06986590 on ClinicalTrials.gov |
What this trial studies
The ADHINCRA Program implements a bundle of multilevel, evidence-based interventions that address patient-, provider-, and health-system factors contributing to uncontrolled hypertension. The program is being delivered at primary care sites in the Ashanti Region of Ghana and at Johns Hopkins in Baltimore, with smartphone-supported components and clinic-based workflow changes. Eligible participants are adults 18–70 with systolic BP ≥140 mmHg who are treatment-naive or on monotherapy, while people with severe hypertension, diabetes, established cardiovascular or kidney disease, pregnancy, or cognitive impairment are excluded. The aim is to increase hypertension control rates and produce a rigorous, scalable model for wider adoption to reduce future cardiovascular, stroke, and kidney disease risk.
Who should consider this trial
Good fit: Adults aged 18–70 with diagnosed hypertension (systolic BP ≥140 mmHg) who are treatment-naive or on a single antihypertensive, receive primary care at a participating site, can consent in a study language, and own a smartphone are ideal candidates.
Not a fit: Patients with severely elevated BP (≥180/110 mmHg), diabetes, prior stroke or coronary or kidney disease, end-stage renal disease on dialysis, pregnancy, cognitive impairment, or those without a smartphone are unlikely to qualify or benefit from this program.
Why it matters
Potential benefit: If successful, the program could improve blood pressure control and lower the risk of heart attack, stroke, and kidney disease by providing a scalable care model.
How similar studies have performed: Similar multilevel and digital-support interventions in low- and middle-income settings have improved blood pressure control in other programs, although effectiveness and scalability have varied by context.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Aged 18 -70 years. * Diagnosis of hypertension and elevated systolic blood pressure measure (≥140 mmHg) on the most recent clinic visit without a diabetes diagnosis. * Hypertension treatment naive or on monotherapy. * Receives primary care at one of the participating sites. * Willing and able to provide informed consent in English, Twi, Dagbani, Ewe, Hausa, or Yoruba. * Owns a smartphone (Android or iOS). Exclusion Criteria: * Age \<18 years or \>70 years. * Severely elevated BP (≥180/110mmHg). * Diagnosis of stroke, coronary artery disease, or kidney disease. * Diagnosis of end-stage renal disease (ESRD) treated with dialysis. * Serious medical condition which either limits life expectancy or requires active management (e.g., cancer). * Cognitive impairment or other conditions preventing study participation * Pregnant or currently nursing a child * Unwilling to provide informed consent
Where this trial is running
Baltimore, Maryland and 16 other locations
- Johns Hopkins University — Baltimore, Maryland, United States (Active_not_recruiting)
- Dominase SDA Hospital — Bekwai, Ashanti Region, Ghana (Not_yet_recruiting)
- Kumasi South Hospital — Kumasi, Ashanti Region, Ghana (Not_yet_recruiting)
- Manhyia Government Hospital — Kumasi, Ashanti Region, Ghana (Recruiting)
- Tafo Government Hospital — Tafo, Ashanti Region, Ghana (Not_yet_recruiting)
- Berekum Holy Family Hospital — Berekum, Bono, Ghana (Not_yet_recruiting)
- St. John of God Catholic Hospital — Duayaw Nkwanta, Bono, Ghana (Recruiting)
- Northern Regional Hospital — Tamale, Northern Region, Ghana (Recruiting)
- Tamale Teaching Hospital — Tamale, Northern Region, Ghana (Not_yet_recruiting)
- Ho Municipal Hospital — Ho, Volta Region, Ghana (Not_yet_recruiting)
- South Tongu District Hospital — Sogakope, Volta Region, Ghana (Not_yet_recruiting)
- Akure South Hospital — Akure, Ondo State, Nigeria (Recruiting)
- Akoko North East — Ondo, Ondo State, Nigeria (Not_yet_recruiting)
- Akoko North West — Ondo, Ondo State, Nigeria (Not_yet_recruiting)
- Akoko South East — Ondo, Ondo State, Nigeria (Not_yet_recruiting)
- Akoko South West — Ondo, Ondo State, Nigeria (Not_yet_recruiting)
- Owo General Hospital — Owo, Ondo State, Nigeria (Not_yet_recruiting)
Study contacts
- Principal investigator: Yvonne Commodore-Mensah, PhD, MHS, RN — Johns Hopkins University
- Study coordinator: Yvonne Commodore-Mensah, PhD, MHS, RN
- Email: ycommod1@jhmi.edu
- Phone: 410-614-1519
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.