{"doi":"10.1093/ajh/hpad037","title":"Peer Counselor Intervention for Reducing Mortality and/or Hospitalization in Adults With Hypertensive Urgency in Tanzania: A Pilot Study","abstract":"BACKGROUND: Worldwide, people with hypertensive urgency experience high rates of hospitalization and death due to medication non-adherence. Interventions to improve medication adherence and health outcomes after hypertensive urgency are urgently needed. METHODS: This prospective cohort assessed the effect of a peer counselor intervention-named Rafiki mwenye msaada-on the 1-year incidence of hospitalization and/or death among adults with hypertensive urgency in Mwanza, Tanzania. We enrolled 50 patients who presented with hypertensive urgency to 2 hospitals in Mwanza, Tanzania. All 50 patients received a Rafiki mwenye msaada an individual-level, time-limited case management intervention. Rafiki mwenye msaada aims to empower adult patients with hypertensive urgency to manage their high blood pressure. It consists of 5 sessions delivered over 3 months by a peer counselor. Outcomes were compared to historical controls. RESULTS: Of the 50 patients (median age, 61 years), 34 (68%) were female, and 19 (38%) were overweight. In comparison to the historical controls, the intervention cohort had a significantly lower proportion of patients with a secondary level of education (22% vs. 35%) and health insurance (40% vs. 87%). Nonetheless, the 1-year cumulative incidence of hospitalization and/or death was 18% in the intervention cohort vs. 35% in the control cohort (adjusted Hazard Ratio, 0.48, 95% CI 0.24-0.97; P = 0.041). Compared to historical controls, intervention participants maintained higher rates of medication use and clinic attendance at both 3- and 6-months but not at 12 months. Of intervention participants who survived and remained in follow-up, >90% reported good medication adherence at all follow-up time points. CONCLUSION: Our findings support the hypothesis that a peer counselor intervention may improve health outcomes among adults living with hypertensive urgency. A randomized clinical trial is needed to evaluate the intervention's effectiveness.","journal":"American Journal of Hypertension","year":2023,"id":384849,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9592,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1152646,"name":"Frank Mgeta","orcid":null,"position":1,"is_corresponding":false},{"id":1152647,"name":"Onike Mcharo","orcid":null,"position":2,"is_corresponding":false},{"id":454418,"name":"Elialilia S. Okello","orcid":"0000-0002-0507-1815","position":3,"is_corresponding":false},{"id":430070,"name":"Bahati Wajanga","orcid":"0000-0002-1922-0746","position":4,"is_corresponding":false},{"id":380453,"name":"Fredrick Kalokola","orcid":"0000-0001-7926-2975","position":5,"is_corresponding":false},{"id":1152648,"name":"Graham Mtui","orcid":null,"position":6,"is_corresponding":false},{"id":310366,"name":"Radhika Sundararajan","orcid":"0000-0002-8451-2243","position":7,"is_corresponding":false},{"id":332197,"name":"Robert N. Peck","orcid":"0000-0002-4526-2480","position":8,"is_corresponding":false},{"id":497670,"name":"Godfrey Kisigo","orcid":"0000-0001-6454-3969","position":0,"is_corresponding":true}],"reference_count":37,"raw_metadata":null,"created_at":"2026-07-19T01:17:37.110513Z","pmid":"37086189","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}