Unmet needs to achieve disease control among patients with hypertension and diabetes, Pathanamthitta, Kerala, India, 2023: A mixed methods study.

Background: This study addresses unmet needs in managing hypertension and diabetes at public health institutions in Pathanamthitta district, Kerala, India, highlighting the significance of non-pharmacological approaches and psychosocial support. Methods: This mixed-methods cross-sectional study was...

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Main Authors: Abey Sushan, Malu Mohan, Aby Robinson, Anjali Krishna, Boopathi Kangusamy, Sendhilkumar Muthappan, Abdulkader Suliankatchi Rizwan
Format: Article
Language:English
Published: Elsevier 2025-05-01
Series:Clinical Epidemiology and Global Health
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Online Access:http://www.sciencedirect.com/science/article/pii/S2213398425001253
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author Abey Sushan
Malu Mohan
Aby Robinson
Anjali Krishna
Boopathi Kangusamy
Sendhilkumar Muthappan
Abdulkader Suliankatchi Rizwan
author_facet Abey Sushan
Malu Mohan
Aby Robinson
Anjali Krishna
Boopathi Kangusamy
Sendhilkumar Muthappan
Abdulkader Suliankatchi Rizwan
author_sort Abey Sushan
collection DOAJ
description Background: This study addresses unmet needs in managing hypertension and diabetes at public health institutions in Pathanamthitta district, Kerala, India, highlighting the significance of non-pharmacological approaches and psychosocial support. Methods: This mixed-methods cross-sectional study was conducted in two phases: a quantitative phase followed by a qualitative phase. 18 Primary Health Centers (PHCs), one urban PHC, and six Community Health Centers (CHCs) were selected through simple random sampling. Patients were interviewed using a structured, interviewer-administered questionnaire. Quantitative data were analyzed and presented as frequencies and percentages, while qualitative data were transcribed and thematically analyzed to identify key themes. Results: We interviewed 346 patients, of whom 144 (41.6 %) had only hypertension, 57 (16.5 %) had only diabetes, and 145 (41.9 %) had both conditions. Hypertension was under control in 89 (31.4 %) patients, while diabetes was under control in 51 (27.7 %) patients. Among the 89 patients with controlled hypertension, most had unmet needs for information about their condition (91.0 %), diet (90.9 %), and exercise (88.8 %). Unmet need for information about disease condition was reported by 44 (88·0 %) of 50 patients who achieved control of diabetes compared to 127 (94·8 %) among 134 patients who did not achieve control. Qualitative data identified meal preparation and household chores as major barriers to effective disease management. Conclusion: Unmet needs are high across domains like information about disease, drug, and exercise. Establishment of community-based support groups for patients with hypertension and/or diabetes to enable collective motivation for sustained lifestyle changes can be explored to achieve better control.
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publishDate 2025-05-01
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spelling doaj-art-cfb20fad68a9426e93584131c0dcef822025-08-20T03:14:35ZengElsevierClinical Epidemiology and Global Health2213-39842025-05-013310203610.1016/j.cegh.2025.102036Unmet needs to achieve disease control among patients with hypertension and diabetes, Pathanamthitta, Kerala, India, 2023: A mixed methods study.Abey Sushan0Malu Mohan1Aby Robinson2Anjali Krishna3Boopathi Kangusamy4Sendhilkumar Muthappan5Abdulkader Suliankatchi Rizwan6ICMR - National Institute of Epidemiology, Chennai, Tamil Nadu, IndiaICMR - National Institute of Epidemiology, Chennai, Tamil Nadu, IndiaICMR - National Institute of Epidemiology, Chennai, Tamil Nadu, IndiaICMR - National Institute of Epidemiology, Chennai, Tamil Nadu, IndiaICMR - National Institute of Epidemiology, Chennai, Tamil Nadu, IndiaICMR - National Institute of Epidemiology, Chennai, Tamil Nadu, IndiaCorresponding author. ICMR-National Institute of Epidemiology, R 127, TNHB, Ayapakkam, Chennai, Tamil Nadu, 600 077, India.; ICMR - National Institute of Epidemiology, Chennai, Tamil Nadu, IndiaBackground: This study addresses unmet needs in managing hypertension and diabetes at public health institutions in Pathanamthitta district, Kerala, India, highlighting the significance of non-pharmacological approaches and psychosocial support. Methods: This mixed-methods cross-sectional study was conducted in two phases: a quantitative phase followed by a qualitative phase. 18 Primary Health Centers (PHCs), one urban PHC, and six Community Health Centers (CHCs) were selected through simple random sampling. Patients were interviewed using a structured, interviewer-administered questionnaire. Quantitative data were analyzed and presented as frequencies and percentages, while qualitative data were transcribed and thematically analyzed to identify key themes. Results: We interviewed 346 patients, of whom 144 (41.6 %) had only hypertension, 57 (16.5 %) had only diabetes, and 145 (41.9 %) had both conditions. Hypertension was under control in 89 (31.4 %) patients, while diabetes was under control in 51 (27.7 %) patients. Among the 89 patients with controlled hypertension, most had unmet needs for information about their condition (91.0 %), diet (90.9 %), and exercise (88.8 %). Unmet need for information about disease condition was reported by 44 (88·0 %) of 50 patients who achieved control of diabetes compared to 127 (94·8 %) among 134 patients who did not achieve control. Qualitative data identified meal preparation and household chores as major barriers to effective disease management. Conclusion: Unmet needs are high across domains like information about disease, drug, and exercise. Establishment of community-based support groups for patients with hypertension and/or diabetes to enable collective motivation for sustained lifestyle changes can be explored to achieve better control.http://www.sciencedirect.com/science/article/pii/S2213398425001253HypertensionDiabetesUnmet needsMixed-methodsIndia
spellingShingle Abey Sushan
Malu Mohan
Aby Robinson
Anjali Krishna
Boopathi Kangusamy
Sendhilkumar Muthappan
Abdulkader Suliankatchi Rizwan
Unmet needs to achieve disease control among patients with hypertension and diabetes, Pathanamthitta, Kerala, India, 2023: A mixed methods study.
Clinical Epidemiology and Global Health
Hypertension
Diabetes
Unmet needs
Mixed-methods
India
title Unmet needs to achieve disease control among patients with hypertension and diabetes, Pathanamthitta, Kerala, India, 2023: A mixed methods study.
title_full Unmet needs to achieve disease control among patients with hypertension and diabetes, Pathanamthitta, Kerala, India, 2023: A mixed methods study.
title_fullStr Unmet needs to achieve disease control among patients with hypertension and diabetes, Pathanamthitta, Kerala, India, 2023: A mixed methods study.
title_full_unstemmed Unmet needs to achieve disease control among patients with hypertension and diabetes, Pathanamthitta, Kerala, India, 2023: A mixed methods study.
title_short Unmet needs to achieve disease control among patients with hypertension and diabetes, Pathanamthitta, Kerala, India, 2023: A mixed methods study.
title_sort unmet needs to achieve disease control among patients with hypertension and diabetes pathanamthitta kerala india 2023 a mixed methods study
topic Hypertension
Diabetes
Unmet needs
Mixed-methods
India
url http://www.sciencedirect.com/science/article/pii/S2213398425001253
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