Feasibility and impact of a patient support group care model on diabetes and hypertension care in informal settlements in Nairobi, Kenya: a quasi-experimental study.

IF 2.2 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Global Health Action Pub Date : 2025-12-01 Epub Date: 2025-04-09 DOI:10.1080/16549716.2025.2482304

Richard E Sanya, Caroline H Karugu, Samuel Iddi, Peter M Kibe, Lilian Mburu, Lilian Mbau, Victor Kibe, Sloan Mahone, Naomi S Levitt, Kerstin Klipstein-Grobusch, Gershim Asiki

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引用次数: 0

Abstract

Background: A support group care model including self-financing is a promising strategy to improve care for patients with diabetes or hypertension in resource-constrained settings.

Objectives: We investigated the uptake, feasibility, and impact of a self-financing patient support group care model on cardiometabolic parameters among adult patients with uncontrolled diabetes or hypertension in informal settlements in Nairobi, Kenya.

Methods: A two-group prospective quasi-experimental study was conducted. The outcomes were changes in mean glycated haemoglobin (HbA1c), systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index, and waist-hip ratio in control versus intervention communities, assessed 6 months after intervention implementation.

Results: At baseline, 118 patients with diabetes (intervention, 60; control, 58) and 176 with hypertension (intervention, 87; control, 89) were enrolled. At endline, 81 patients with diabetes and 137 with hypertension were surveyed. In the intervention arm, HbA1c decreased from 10.8% to 9.0% (mean difference [95% CI]: -1.7 [-2.4, -0.9] p < 0.001) and in the control arm from 10.6% to 9.9% (-0.9 [-1.5, -0.3] p = 0.005). Difference-in-difference analysis showed a notably greater reduction in HbA1c in the intervention arm (-0.942 [0.463] p < 0.05). In the intervention arm, SBP decreased from 155.0 mmHg to 148.7 mmHg (-6.3 [-11.7, -0.9] p = 0.022) and in the control arm, from 160.1 mmHg to 152.5 mmHg (-7.6 [-12.9, -2.3] p = 0.005). DBP in the intervention arm changed from 99.1 mmHg to 97.9 mmHg (-1.1 [4.2, 1.9] p = 0.462) and in the control arm from 99.7 mmHg to 94.8 mmHg (-4.9 [7.8, -2.0] p = 0.001).

Conclusions: A self-financing patient support group care model is feasible, improves cardiometabolic parameters and can be a strategy to manage diabetes, hypertension, and other chronic diseases in low-resource settings.

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肯尼亚内罗毕非正式住区患者支持团体护理模式对糖尿病和高血压护理的可行性和影响：一项准实验研究

背景：在资源有限的环境下，包括自筹资金在内的支持团体护理模式是一种有希望改善糖尿病或高血压患者护理的策略。目的：我们调查了在肯尼亚内罗毕非正式定居点中，自费患者支持团体护理模式对未控制的糖尿病或高血压成年患者心脏代谢参数的吸收、可行性和影响。方法：采用两组准实验方法进行前瞻性研究。结果是在干预实施6个月后评估对照组与干预组的平均糖化血红蛋白（HbA1c）、收缩压（SBP）、舒张压（DBP）、体重指数和腰臀比的变化。结果：基线时，118例糖尿病患者(干预，60例；对照组58例，高血压176例(干预组87例；对照组为89例。最后，81例糖尿病患者和137例高血压患者接受了调查。在干预组，HbA1c从10.8%下降到9.0%（平均差异[95% CI]: -1.7 [-2.4, -0.9] p = 0.005）。差异分析显示，干预组的HbA1c显著降低（-0.942 [0.463]p = 0.022），对照组的HbA1c从160.1 mmHg降至152.5 mmHg （-7.6 [-12.9, -2.3] p = 0.005）。干预组DBP从99.1 mmHg变为97.9 mmHg (-1.1 [4.2, 1.9] p = 0.462)，对照组DBP从99.7 mmHg变为94.8 mmHg （-4.9 [7.8, -2.0] p = 0.001）。结论：自费患者支持团体护理模式是可行的，可改善心脏代谢参数，并可作为低资源环境中管理糖尿病、高血压和其他慢性疾病的策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Global Health Action PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

5.10

自引率

3.80%

发文量

108

审稿时长

16 weeks

期刊介绍： Global Health Action is an international peer-reviewed Open Access journal affiliated with the Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine at Umeå University, Sweden. The Unit hosts the Umeå International School of Public Health and the Umeå Centre for Global Health Research. Vision: Our vision is to be a leading journal in the global health field, narrowing health information gaps and contributing to the implementation of policies and actions that lead to improved global health. Aim: The widening gap between the winners and losers of globalisation presents major public health challenges. To meet these challenges, it is crucial to generate new knowledge and evidence in the field and in settings where the evidence is lacking, as well as to bridge the gaps between existing knowledge and implementation of relevant findings. Thus, the aim of Global Health Action is to contribute to fuelling a more concrete, hands-on approach to addressing global health challenges. Manuscripts suggesting strategies for practical interventions and research implementations where none already exist are specifically welcomed. Further, the journal encourages articles from low- and middle-income countries, while also welcoming articles originated from South-South and South-North collaborations. All articles are expected to address a global agenda and include a strong implementation or policy component.