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.
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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DOI：
10.1136/bmjopen-2020-047425
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发表时间：
2021-09-21
期刊：
影响因子：
2.9
通讯作者：
Waheed G
中科院分区：
文献类型：
--
作者：
Brady EM;EXTEND Collaborative;Bamuya C;Beran D;Correia J;Crampin A;Damasceno A;Davies MJ;Hadjiconstantinou M;Harrington D;Khunti K;Levitt N;Magaia A;Mistry J;Namadingo H;Rodgers A;Schreder S;Simango L;Stribling B;Taylor C;Waheed G
全球估计有4.25亿2型糖尿病（T2 D）患者，其中80%来自中低收入国家（LMIC）。糖尿病自我管理教育（DSME）计划是T2 D治疗途径的重要和核心组成部分。尽管LMIC受到T2 D的不利影响，但没有符合国际糖尿病联合会标准的DSME可用。目的是测试在马拉维和莫桑比克两个城市环境中为英国人群提供经证明有效且具有成本效益的方法的可行性：（1）开发文化，背景和语言适应的DSME，扩展中低收入国家2型糖尿病患者自我管理结构化教育计划的可用性（EXTEND）计划;（2）使用混合方法评估T2 D患者的培训和EXTEND计划。培训了12名保健专业人员。98名参与者收到了DSME。保留率很高（莫桑比克100%，马拉维94%）。6个月时，HbA 1c（−0.9%）、胆固醇（−0.3 mmol/L）、血压（收缩压−5.9 mm Hg和舒张压−6.1 mm Hg）以及健康指标（糖尿病问题领域和糖尿病自我效能）均有所改善。这是可行的，提供和评估的文化，语境和语言适应扩展计划在两个LMIC的有效性。DSME是可以接受的积极的生物医学和心理结果，但需要正式的测试与成本效益。在没有资源应对糖尿病挑战的卫生系统中推广这种方法存在挑战。
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. 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. 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). 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.
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影响因子：
16.2
作者：
通讯作者：
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糖尿病教育和自我管理计划（DESMOND）的有效性对于新诊断的2型糖尿病患者：梅利氏菌的糖尿病：三年的初级保健随机对照试验的随访。
DOI：
10.1136/bmj.e2333
发表时间：
2012-04-26
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Khunti K;Gray LJ;Skinner T;Carey ME;Realf K;Dallosso H;Fisher H;Campbell M;Heller S;Davies MJ
通讯作者：
Davies MJ
影响因子：
2.8
作者：
Steinsbekk A;Rygg LØ;Lisulo M;Rise MB;Fretheim A
通讯作者：
Fretheim A
影响因子：
3.5
作者：
Deakin, T. A.;Cade, J. E.;Greenwood, D. C.
通讯作者：
Greenwood, D. C.
影响因子：
105.7
作者：
Stratton, IM;Adler, AI;Holman, RR
通讯作者：
Holman, RR