Understanding the treatment burden of people with chronic conditions in Kenya: A cross-sectional analysis using the Patient Experience with Treatment and Self-Management (PETS) questionnaire.
Understanding the treatment burden of people with chronic conditions in Kenya: A cross-sectional analysis using the Patient Experience with Treatment and Self-Management (PETS) questionnaire.
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DOI：
10.1371/journal.pgph.0001407
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Perel, Pablo
中科院分区：
文献类型：
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作者：
Koros, Hillary;Nolte, Ellen;Kamano, Jemima;Mugo, Richard;Murphy, Adrianna;Naanyu, Violet;Willis, Ruth;Pliakas, Triantafyllos;Eton, David T;Barasa, Edwine;Perel, Pablo
在肯尼亚，非传染性疾病日益成为发病和死亡的重要原因，需要更好地获得保健服务和自我保健支持。有证据表明，治疗负担会对治疗依从性和生活质量产生负面影响。在这项研究中，我们探讨了肯尼亚西部两个县的非传染性疾病患者的治疗和自我管理负担。我们使用患者治疗和自我管理经验（PETS）工具对新诊断为糖尿病和/或高血压的患者进行了横断面调查。共有301名糖尿病和/或高血压患者完成了调查（63%为女性，平均年龄= 57岁）。他们报告说，在医疗和保健费用、健康监测、与自我管理有关的疲惫、饮食和锻炼/物理治疗领域的治疗负担最高。治疗负担得分因县、年龄、性别、教育、收入和慢性病数量而异。年轻的受访者（<60岁）报告了药物副作用（p<0.05），饮食（p<0.05）和医疗预约（p = 0.075）的较高负担。那些没有受过正规教育或低收入的人也报告了更高的饮食和医疗费用负担。有医疗保险的人报告的更低我们的研究结果为肯尼亚和政府正在努力实现全民健康覆盖的类似环境提供了重要的见解，强调了财务保护的重要性，不仅可以防止因慢性病寻求医疗保健的经济负担，而且可以减轻相关的治疗负担。
In Kenya, non-communicable diseases (NCDs) are an increasingly important cause of morbidity and mortality, requiring both better access to health care services and self-care support. Evidence suggests that treatment burdens can negatively affect adherence to treatment and quality of life. In this study, we explored the treatment and self-management burden among people with NCDs in in two counties in Western Kenya. We conducted a cross-sectional survey of people newly diagnosed with diabetes and/or hypertension, using the Patient Experience with Treatment and Self-Management (PETS) instrument. A total of 301 people with diabetes and/or hypertension completed the survey (63% female, mean age = 57 years). They reported the highest treatment burdens in the domains of medical and health care expenses, monitoring health, exhaustion related to self-management, diet and exercise/physical therapy. Treatment burden scores differed by county, age, gender, education, income and number of chronic conditions. Younger respondents (<60 years) reported higher burden for medication side effects (p<0.05), diet (p<0.05), and medical appointments (p = 0.075). Those with no formal education or low income also reported higher burden for diet and for medical expenses. People with health insurance cover reported lower (albeit still comparatively high) burden for medical expenses compared to those without it. Our findings provide important insights for Kenya and similar settings where governments are working to achieve universal health coverage by highlighting the importance of financial protection not only to prevent the economic burden of seeking health care for chronic conditions but also to reduce the associated treatment burden.