Community Health Worker Interventions in Type 2 Diabetes Mellitus Patients: Assessing the Feasibility and Effectiveness in Rural Central India

Abstract

Background: Globally, across high as well as low-income countries, there is a sub-optimal glycemic control amongst Type 2 diabetes mellitus patients. Communitybased programmes with the help of community health workers (CHWs) have been tried to offer culturally appropriate care leading to positive impact on glycemic control. Methods: We planned this open-label randomised controlled trial to assess the possibility of CHWs interventions in a rural community in central India. We designed this study to compare glycaemic control, lipid profile, blood pressure and anthropometric measurements between patients in the CHW intervention group and those in the standard therapy group. The intervention group was offered CHW interventions in the form of home visits, health education, patient diary, telephonic reminders etc as compared to standard care group that received usual care. Results: We included a total of 299 patients in our study (standard care group n= 146 and intervention group n= 153) and followed them for a period of 6 months (96.98% follow up data) and recorded outcome variables (fasting blood sugar, post-prandial blood sugar, glycosylated haemoglobin, lipid profile, blood pressure) at the start and end of the study. Both the standard care group and intervention group showed improved in their glycemic indices at the end of the study. We established no statistical difference between the intervention and the standard care group at the end of the study. The mean reduction of HbA1c and fasting blood sugar was more in the intervention group as compared to the standard care group. Conclusion: Our study demonstrated a trend towards improvement in glycemic indices in the intervention group as compared to the standard care group.