Abstract TH836: WinCare 2.0—An Innovative Nonmedical-Care Provider Network for Older Adults With Hypertension: Effects on Blood Pressure Control, Health Status, and Predicted 10-Year Cardiovascular Risk in Urban Primary Care in Eastern Thailand

Abstract

Background: WinCare 2.0, an innovative home-care provider network, aims to deliver continuous, proactive, people-centered primary health care. It comprises two components: (1) trained community-based home-care providers and (2) the WinCare mobile application. We evaluated the effects of WinCare 2.0 on blood pressure (BP) control, health status (0-100), and predicted 10-year cardiovascular disease (CVD) risk among older adults with hypertension (HTN) receiving care in urban primary care settings in Rayong Province, Eastern Thailand. Methods: We conducted a prospective cohort study (May–August 2025) among adults aged ≥60 years with HTN at two urban primary care units. Participants were nonrandomly allocated to WinCare 2.0 (intervention) or usual care (control). In the intervention group, trained WinCare providers made weekly in-person visits for four months, monitored home BP, measured weight, provided nonmedical support, and recorded data in the WinCare app. Outcomes at 2 and 4 months were estimated using generalized estimating equations, adjusting for demographics, comorbidities, and lifestyle factors. Results: We enrolled 102 participants (mean age 71.7 ± 7.1 years; 83.3% women): 54 in WinCare and 48 in the control group. WinCare group showed larger declines in systolic BP: −11.6 mmHg (95% CI: −16.5, −6.5) at 2 months and −5.7 mmHg (95% CI: −10.4, −1.0) at 4 months; changes in controls were -4.3 mmHg (95% CI: -9.8, 1.14) at 2 months and -2.6 mmHg (95% CI: -8.9, 3.6) at 4 months. Controlled HTN (<140/90 mmHg) increased by 24.1% (95% CI: 3.6, 44.6) at 2 months and 24.2 % (95% CI: 6.1, 39.0) at 4 months in WinCare, with no significant change in controls by 2.1% and by 0.74% at 2 and 4 months, respectively. Optimal-target HTN control increased by 32.0% (95% CI: 11.3, 52.7) at 2 months and 33.2% (95% CI: 13.0, 53.3) at 4 months in WinCare; the control group showed no improvement (Figure 1). At 4 months, health status increased by 6.2 (95% CI: 1.8, 10.7) in WinCare versus −3.7 (95% CI: −9.3, 2.0) in controls. Predicted 10-year CVD risk fell by 1.6% (95% CI: -2.3, -0.8) and 0.8% (95% CI: -1.5, -0.1) at 2 and 4 months, respectively, in WinCare, and fell by 0.5% and 0.4% in controls. Conclusion: WinCare 2.0 was associated with clinically meaningful improvements in BP outcomes, health status, and predicted 10-year CVD risk among older adults with HTN in urban primary care in Eastern Thailand, supporting a people-centered, community-based model for chronic disease management.