Patient-led support groups in the management of hypertension and diabetes in low-resource settings: mixed methods study of an innovative model
Medical Research Council
African Population and Health Research Center
The long term ambition of this project is to improve the lives of low and middle-income people living with untreated hypertension and diabetes across Africa through a patient-led model of care. Our work is motivated by the rising burden of hypertension and diabetes in a rapidly urbanising Africa and scarce public resources for managing patients. Patient support groups have gained considerable interest as a strategy to reach low-income patients, however, there is insufficient evidence to scale up such groups widely. We have seen a window of opportunity in long-lived experiences of 6 patient groups in the slums of Nairobi and we want to interview these patients and co-design a model of care and evaluate the feasibility of conducting a large trial. We plan to conduct this through three interrelated work packages. The first work package will be a mixed methods approach starting with ethnographies, focus group discussions, in-depth interviews and survey of patients in the groups. Key informant interviews of healthcare providers will also be conducted. A literature review to assess the adaptability of the models in Africa will follow. This formative work will inform the design of a model that we will pilot (work package 2) in two communities in Nairobi slums. The novel data from the pilot will inform design, sample size, logistical considerations for a multi-country trial. We have assembled a multi-disciplinary team to undertake this task. The last work package (work package 3) entails networking with stakeholders to disseminate findings and for investigators to plan the design of a large trial. We anticipate this work to be completed in 24 months.
7.3 Management and decision making / Research Grant