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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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.