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Dryad

Retrospective cohort study of a community-based primary care program's effects on pharmacotherapy quality in low-income Peruvians with type 2 diabetes and hypertension

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Abstract

A door-to-door survey was conducted to enumerate all household members by age and sex in a low-income community in Peru. 856 adults 35 years and older were eligible to participate in screening for type 2 diabetes and hypertension. 709 (83%) participated in screening. 130 (18.3%) were diagnosed with hypertension and/or type 2 diabetes of which 109 (84%) participated at program onset and 22 were added later from earlier non-participants in screening or program onset to form the cohort of 131 patients with diabetes and/or hypertension. The primary care program had components of the Chronic Care Model, community health workers, and freely accessible visits and medications. The program operated between September 2011 and May 2014, and consisted of two care periods (separated by a six-month hiatus), first a 10-month home-care period, then a 17-month clinic-care period. The dataset is two files corresponding to two exposures: the 27-month program overall (post- versus pre-) (N=262 observations, 131 pairs with patients as self-controls) and care period (clinic versus home), N=211 (109 home and 102 clinic observations, >131 because 80 patients participated in both care periods). Exposures were evaluated for their effects on guidelines-based pharmacotherapy standards: hypoglycemic and antihypertensive medications, low-dose aspirin, and first-line angiotensin converting enzyme inhibitor (ACEi) treatment of diabetes with elevated blood pressure.