Article Figures & Data
Figures
- Figure 1 Sampling for interviews. RHC = rural health centre. THQ = Tehsil headquarters.
- Figure 2 Patient attrition in intervention and control arms
Tables
Care task Key indicators Quantitative Qualitative Screening and diagnosis 1. Number of patients with diabetes registered, as percentage of overall outpatient attendance2. Number and percentage of patients examined for baseline clinical and laboratory, and age/anthropometric measurements Patient’s and provider’s experiences, as well as practice deviations and reasons for: identifying and examining patients who are overweight or symptomatic of diabetes mellitus
conducting clinical and laboratory exams, and diagnosis
Prescriptions 3. Number and percentage of patients prescribed as per guidelines for diabetes and/or hypertension: without comorbid condition
with comorbid condition (renal insufficiency; pregnancy)
Patient’s and provider’s experiences, as well as practice deviations and reasons for: prescribing, as per guide
trialling lifestyle changes before drugs
prescribing preventive drugs
Lifestyle modification 6. Recording of smoking status and staff response Patient’s and provider’s experiences, as well as practice deviations and reasons for: counselling patient (with pictorial tool) for lifestyle change and smoking cessation
estimating and use of 'target weight' for patient counselling
Follow-up and adherence 7. Number and percentage of patients adhering to follow-up visits (in first 9 months) 8. Number and percentage of patients examined (clinical/ laboratory) on follow-up visits 9. Number and percentage of patients referred for expert check-up and/or complication and/or severe drug reaction Patient’s and provider’s experiences, as well as practice deviations and reasons for: patient adherence to follow-up visits (include retrieval)
staff adherence to care during follow-up visit
referrals (for example, side effects)
Material inputs Patient’s and provider’s experiences, as well as practice deviations and reasons for: maintaining uninterrupted inputs
coping with input gaps and/or challenges
Intervention inputs Intervention process and actions Intended Practice change Outputs Health outcome Case management desk guide and lifestyle counselling tool
Training of doctors and allied staff (on full care package)
Supplement drugs, equipment and supplies (digital blood pressure apparatus, glucometer, and strips)a
Recording formsa
Screen/diagnosea
Prescribe anti-diabetic drugs
Identify co-morbid condition and treat
Counsel for lifestyle modification
Follow-up care, including retrieval
Providers practise programme protocols to: Screen, diagnose, treat, counsel, follow-up, and report as per programme protocol
Follow-up visits
Treatment
Lifestyle changes (as counselled)
Patients gets: Screened and diagnosed as per programme protocol
Prescribed right drug/ dose
Counselled for lifestyle change
Followed-up and treated for continued care
Reduction (0.5%) in mean HbA1c
Increased proportion achieving HbA1c <7%.
Reduction in complications related to diabetes
aInputs/ practices kept same in intervention and control arms.
Arm Treatment without associated proteinuria Treatment with associated proteinuria Biguanide Others Total Sulphonylurea Others Total n % n % n % n % n % n % Intervention 141 63.2 82 36.8 223 100 14 53.8 12 46.2 26 100 Control 91 42.5 123 57.5 214 100 7 23.3 23 76.7 30 100 Total 232 53.1 205 46.9 437 100 21 37.5 35 62.5 56 100 Arm Eligible Treated Raised blood pressure Smokers Total n % Intervention 60 37 97 5 5.1 Control 68 28 96 13 13.5 Total 128 65 193 18 9.3
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