Unmet needs to achieve disease control among patients with hypertension and diabetes, Pathanamthitta, Kerala, India, 2023: A mixed methods study.

AbstractBackground This study addresses unmet needs in managing hypertension and diabetes at public health institutions in Pathanamthitta district, Kerala, India, highlighting the significance of non-pharmacological approaches and psychosocial support. Methods This mixed-methods cross-sectional study was conducted in two phases: a quantitative phase followed by a qualitative phase. 18 Primary Health Centers (PHCs), one urban PHC, and six Community Health Centers (CHCs) were selected through simple random sampling. Patients were interviewed using a structured, interviewer-administered questionnaire. Quantitative data were analyzed and presented as frequencies and percentages, while qualitative data were transcribed and thematically analyzed to identify key themes. Results We interviewed 346 patients, of whom 144 (41.6 %) had only hypertension, 57 (16.5 %) had only diabetes, and 145 (41.9 %) had both conditions. Hypertension was under control in 89 (31.4 %) patients, while diabetes was under control in 51 (27.7 %) patients. Among the 89 patients with controlled hypertension, most had unmet needs for information about their condition (91.0 %), diet (90.9 %), and exercise (88.8 %). Unmet need for information about disease condition was reported by 44 (88·0 %) of 50 patients who achieved control of diabetes compared to 127 (94·8 %) among 134 patients who did not achieve control. Qualitative data identified meal preparation and household chores as major barriers to effective disease management. Conclusion Unmet needs are high across domains like information about disease, drug, and exercise. Establishment of community-based support groups for patients with hypertension and/or diabetes to enable collective motivation for sustained lifestyle changes can be explored to achieve better control.