Extending availability of self-management structured education programmes for people with type 2 diabetes in low-to-middle income countries (EXTEND) : a feasibility study in Mozambique and Malawi

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Brady, Emer M and Bamuya, Catherine and Beran, David and Correia, Jorge and Crampin, Amelia and Damasceno, Albertino and Davies, Melanie J. and Hadjiconstantinou, M. and Harrington, Deirdre and Khunti, Kamlesh and Levitt, Naomi and Magaia, Ana and Mistry, Jayna and Namadingo, Hazel and Rodgers, Anne and Schreder, Sally and Simango, Leopoldo and Stribling, Bernie and Taylor, Cheryl and Waheed, Ghazala (2021) Extending availability of self-management structured education programmes for people with type 2 diabetes in low-to-middle income countries (EXTEND) : a feasibility study in Mozambique and Malawi. BMJ Open, 11 (9). pp. 1-12. ISSN 2044-6055 (https://doi.org/10.1136/bmjopen-2020-047425)

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Abstract

Background Globally, there are estimated 425 million people with type 2 diabetes (T2D) with 80% from low-middle income countries (LMIC). Diabetes self-management education (DSME) programmes are a vital and core component of the treatment pathway for T2D. Despite LMIC being disproportionally affected by T2D, there are no DSME available that meet international diabetes federation criterion. Methods The aims were to test the feasibility of delivering a proven effective and cost-effective approach used in a UK population in two urban settings in Malawi and Mozambique by; (1) developing a culturally, contextually and linguistically adapted DSME, the EXTending availability of self-management structured EducatioN programmes for people with type 2 Diabetes in low-to-middle income countries (EXTEND) programme; (2) using a mixed-method approach to evaluate the delivery of training and the EXTEND programme to patients with T2D. Results Twelve healthcare professionals were trained. Ninety-eight participants received the DSME. Retention was high (100% in Mozambique and 94% in Malawi). At 6 months HbA1c (−0.9%), cholesterol (−0.3 mmol/L), blood pressure (−5.9 mm Hg systolic and −6.1 mm Hg diastolic) improved in addition to indicators of well-being (problem areas in diabetes and self-efficacy in diabetes). Conclusion It is feasible to deliver and evaluate the effectiveness of a culturally, contextually and linguistically adapted EXTEND programme in two LMIC. The DSME was acceptable with positive biomedical and psychological outcomes but requires formal testing with cost-effectiveness. Challenges exist in scaling up such an approach in health systems that do not have resources to address the challenge of diabetes.

ORCID iDs

Brady, Emer M, Bamuya, Catherine, Beran, David, Correia, Jorge, Crampin, Amelia, Damasceno, Albertino, Davies, Melanie J., Hadjiconstantinou, M., Harrington, Deirdre ORCID logoORCID: https://orcid.org/0000-0003-0278-6812, Khunti, Kamlesh, Levitt, Naomi, Magaia, Ana, Mistry, Jayna, Namadingo, Hazel, Rodgers, Anne, Schreder, Sally, Simango, Leopoldo, Stribling, Bernie, Taylor, Cheryl and Waheed, Ghazala;
  • Item type:Article
    ID code:84619
    Dates:
    Date
    Event
    21 September 2021
    Published
    12 August 2021
    Accepted
    Notes:Brady EM, , Bamuya C, et alEXTending availability of self-management structured EducatioN programmes for people with type 2 Diabetes in low-to-middle income countries (EXTEND)—a feasibility study in Mozambique and MalawiBMJ Open 2021;11:e047425. doi: 10.1136/bmjopen-2020-047425
    Subjects:Medicine
    Education
    Department:Faculty of Humanities and Social Sciences (HaSS) > Psychological Sciences and Health > Physical Activity for Health
    Depositing user: Pure Administrator
    Date deposited:09 Mar 2023 14:09
    Last modified:20 Dec 2024 03:51
    URI:https://strathprints.strath.ac.uk/id/eprint/84619
CORE (COnnecting REpositories)