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Friday, 22 April 2016 09:10

Clinical Research: Yes, we can do primary prevention - But is it really effective in reducing risks?

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image PaudelName: Dr Klara Paudel

Hospital / Affiliation: Charak Memorial Hospital

Home Country: Nepal

Host Country: Nepal

Year (starting year): 2014

Status of your program: In progress 




“Yes, we can do primary prevention – But is it really effective in reducing risks?”


Chronic kidney disease 


Short Description of the Project or Abstract:

The project is a randomized controlled trial to evaluate the effectiveness of a well-organized life-style intervention program in the community in the rural and urban Nepal. Local trained peer educators conduct the intervention part of the program. Control groups receive standard care and initial education, while intervention groups are followed up for one year by regular visits and reminders for the life style changes they need. Inclusion criteria for recruitment are high risk people eg. they have any one of the following criteria: hypertension, diabetes mellitus, obesity (BMI>30), CKD, smoking, alcohol consumption (>30g/day) or inactivity.

The recruitment plan is 500 persons from 10 rural areas and 500 persons from 10 urban areas. In order to avoid contamination, the randomization is done according to geographic areas. The follow-up period is 12 months. Outcome measures are the reduction in risk factors and adherence to life-style changes. Both the intervention and the control group receives initial counselling and health advise. The control group is contacted only after one year and there is no further counseling by our team during the one year period. 

The intervention group is followed up initially monthly then 3 monthly by a peer educator who gives personalized advice and support, re-enforces information and the importance of control of the risk factors. After the study period we follow-up our population once yearly for two additional years, to establish evidence about the sustainability of those changes. We expect that in both groups there will be some reduction in risk factors, but in the intervention group would be to a greater extent. If the peer educator program is successful, it could be promoted as nation-wide program, given the feasibility and the low cost of training and maintaining them.


Learning or Research Objectives:

  • Measure the extent of risk reduction by life-style interventions over one year.
  • Compare the rural and urban population in the extent of risk reduction
  • Assess the sustainability of the effects of the program in the spam of 3 years and assess the rate of new onset of diseases in the two groups and mortality
  • Evaluate the feasibility of training peer educators and calculate cost-benefit of peer educator program. With the results of efficiency and benefit we can raise awareness and draw the attention of government bodies to support and sponsor such programs.
    This project can be an initial step in setting up a model for a nation-wide peer educator prevention program.

Additional Info

  • Year: 2014
  • Status: In progress
  • Partners: ISN only
  • Region: South Asia
  • Country: Nepal
  • Topics: CKD
Read 6571 times Last modified on Wednesday, 27 April 2016 10:17

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