HEAT (Heat Emergency Awareness and Treatment Bundle) Trial

Purpose

The purpose of this study was to develop and test a set of interventions to reduce the impact of extreme heat on urban low-income populations. There were three main objectives:

1. To develop evidence based care strategies for management of people with exposure to extreme heat (EH) in both households and emergency departments in low income settings such as Pakistan;
2. To implement Heat Emergency Education and Training (HEAT) bundle in Karachi and measure its impact on a composite outcome comprising of emergency department admissions, hospital admissions and all-cause mortality
3. To determine the impact of HEAT implementation on the knowledge and care practices in households and emergency departments.

Outcomes

The study developed and tested a set of interventions called Heat Emergency Education and Treatment (HEAT), which were designed using current evidence, international best practices, and with relevance to low resource settings. The study filled several critical gaps in research by carrying out the first randomised controlled trial comprised of a set of customised community- and hospital-based interventions in a low-income urban population, with inclusion of a control group of similar socio-economic status in the same city.

The study also include standardised assessment for categorising causes of heat related morbidity and mortality, and attempted to control for some of the important external confounders by collecting data before the intervention was carried out. In order to align the research intervention with what could be done in real life, the study team relied on indigenous community health mobilisers and the infrastructure present in local healthcare facilities.