LAUSR

Objectives: Low awareness and control of hypertension in Africa contributes to the increase in cardiovascular disease morbidity and mortality. Home-based screening by health workers empowered with one digital application could improve awareness and control. The objective of this study is to assess the clinical and economic consequences of the use of Ganeo-app, one digital tool used by community health workers (CHWs) to performed home-based screening and education of patients with hypertension. Methods: A decision tree combined with a Markov model was used to simulate health outcomes and compare the impact of use of GANEO-App to the current situation in Cameroon. The expected number of events averted and cost savings were simulated in three scenarios: i) increase awareness rate ii) increase awareness rate and proportion of people who started a lifestyle change iii) increase of awareness rate; proportion of people who started a life style change and proportion of people on treatment. Input parameters for the models were informed by the literature. Results: Simulation was applied to a cohort of 10 000 people. After 5 years, results of the first scenario showed that compared to current situation, home-based screening with Ganeo – App could avoid about 8.5 cases of strokes, 9.1 cases of coronary heart diseases, 7.4 deaths. Considering medical costs, 6.8 million FCFA (10,255 euros) could be saved on strokes for example with digital screening. Health impacts and savings were more important in other scenario. Conclusion: Prevention of cardiovascular events through home-based screening with digital tool by CHW could result in significant reduction in morbidity, thereby effecting substantial cost saving. Home-based digital screening could be a cost effective option to improve the control of hypertension in Africa.