TY - JOUR
T1 - Feasibility and impact of a patient support group care model on diabetes and hypertension care in informal settlements in Nairobi, Kenya
T2 - a quasi-experimental study
AU - Sanya, Richard E.
AU - Karugu, Caroline H.
AU - Iddi, Samuel
AU - Kibe, Peter M.
AU - Mburu, Lilian
AU - Mbau, Lilian
AU - Kibe, Victor
AU - Mahone, Sloan
AU - Levitt, Naomi S.
AU - Klipstein-Grobusch, Kerstin
AU - Asiki, Gershim
N1 - Publisher Copyright:
© 2025 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
PY - 2025
Y1 - 2025
N2 - 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.
AB - 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.
KW - Africa
KW - diabetes
KW - Hypertension
KW - low- and middle-income countries
KW - patient support groups
KW - self-financing
UR - http://www.scopus.com/inward/record.url?scp=105002330766&partnerID=8YFLogxK
U2 - 10.1080/16549716.2025.2482304
DO - 10.1080/16549716.2025.2482304
M3 - Article
AN - SCOPUS:105002330766
SN - 1654-9880
VL - 18
JO - Global Health Action
JF - Global Health Action
IS - 1
M1 - 2482304
ER -
