Abstract 4370478: Effectiveness of Mobile Medical Clinics in Blood Pressure Control in Low Resource Settings

Abstract

Background: In low-resource settings, limited healthcare access contributes to uncontrolled hypertension and elevated cardiovascular risk. Mobile medical clinics (MMCs) offer a potential solution, yet evidence of their long-term effectiveness remains limited. Hypothesis: This study evaluated whether MMCs improve blood pressure (BP) control in hypertensive adults and whether greater follow-up adherence enhances outcomes. We hypothesized that more frequent visits would be associated with greater BP reductions and higher rates of achieving guideline-recommended targets. Methods: A retrospective cohort study was conducted using electronic medical records of adults aged ≥19 years who accessed MMC services across 15 underserved communities from 2017 to 2019 in Pampanga, Philippines. Adults with hypertension and ≥1 comorbid non-communicable disease were included if they had ≥2 visits with documented blood pressure measurements. Good follow-up, reflecting continuity of care, was defined as attending at least 50% of expected visits. Outcomes included changes in systolic and diastolic blood pressure. Program reach was assessed using entry, participation, and retention rates. Statistical analyses included t-tests, chi-squared tests, and adjusted linear and logistic regressions. Results: Of 6,562 MMC users, 1,839 (28%) had hypertension with a chronic comorbidity and 266 met inclusion criteria (mean age 59.5 ± 9.9 years, 75% female, 51% with diabetes). Program entry increased from 2.9% to 27.1% over three years, with higher uptake in rural than urban communities (30.1% vs 18.7%, p<0.001). Among patients with good follow-up (n=114, mean adherence 71%), systolic and diastolic blood pressure decreased significantly by visit five (−7.8 ± 0.9 mmHg and −5.0 ± 0.8 mmHg, p<0.001), and target blood pressure achievement rose from 15.8% to 56.1% (p<0.001). Good follow-up was associated with an additional 4.2 mmHg systolic reduction (95% CI: −6.7 to −1.7) and 2.8 times higher odds of blood pressure control (95% CI: 1.7–4.6). No significant changes were observed among patients with poor follow-up. Conclusion: MMCs effectively improve hypertension control in low-resource settings, particularly with consistent follow-up. Findings support broader adoption of MMCs with enhanced retention strategies to maximize impact.