Abstract
Objective: Novel approaches are required in order to detect and manage hypertension in low and middle-income countries. One model is by using barbershops as a contact platform to engage with patients on a regular basis. We explored the evidence for the contemporary role of barbershop led interventions to manage hypertension in community setting, by only including randomized controlled clinical trials (RCCTs) Design and method: We searched Cochrane Library, pubmed- MEDLINE, IndMED online databases to conduct a systematic review of the published RCCTs. Studies with non-barbershop led, generalised community-based setting approaches were excluded by using the Boolean operators. Graphpad was utilised for statistical analysis Results: The results yielded four clinical trials of which three met inclusion criteria, published in last 10 years (2011 to 2019). The parameters were analysed for the study design, patient characteristics, impact factor of the journals, duration, and outcomes. Cumulatively, 1826 subjects (mean 609 subjects, SD ± 367, SEM ± 212, minimum 319, maximum 1022, range 703, 95% CI -304 to 1521, p = 0.103 NS) have been evaluated across three RCCTs. The cumulative duration of the trials was 32 months (mean 11 months, SD ± 1.2, SEM ± 0.67, minimum 10, maximum 12, range 2, 95% CI 7.8 to 13.5, p = 0.0039). The baseline systolic BP of upto 140 mm Hg has been the uniform enrolment criteria. Based on the impact factor of the journals (mean 31, SD ± 35, SEM ± 20, minimum 2.8, maximum 71, range 68, 95% CI -56 to 119; p = 0.26 NS), we formulated an indexed weightage score (mean 100, minimum 9, maximum 225, SD ± 112, SEM ± 65, range 216, 95% CI -178 to 378, p = 0.26 NS). The patients who were treated with specialists, received more BP medication and different classes of medication than those treated by primary care physicians and BP reduction was 21 mmHg (p < 0.0001) Conclusions: Barber based intervention model have demonstrated to be a feasible connect between the patients and healthcare providers resulting in sustained BP reductions in the community, especially when care linkage to hypertension specialists can be achieved
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