Primary Care 101 Trial
Evidence on the effectiveness of the Primary Care 101 guideline
This pragmatic randomised controlled trial was conducted during 2011-2013 in 38 clinics in the Eden and Overberg districts of the Western Cape, South Africa. It aimed to test whether the Primary Care 101 programme improved quality of primary care for adult chronic diseases. The trial evaluated treatment outcomes for hypertension, diabetes, chronic respiratory disease and the detection of depression. 4393 patients were interviewed in 2011 at baseline and re-interviewed approximately 14 months later. A 90% follow up rate was achieved.
Two papers have been published (1, 2) and the main findings submitted for publication. Baseline data suggests high rates of multimorbidity, under-treatment and poor control of non-communicable diseases. A limited qualitative review indicated that the programme was well-received in spite of nurses having to cope with the back-log of sub-optimally managed patients and the increased workload associated with this. Although superiority of the intervention on the primary outcomes for the four target diseases was not demonstrated, health authorities in South Africa view the programme as coherent, feasible and acceptable, and have committed to rolling it out nationally.