ArticleBMJ open2020
Improving primary care for diabetes and hypertension: findings from implementation research in rural South India.
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Implementation strategies for evidence-based management of type 2 diabetes at primary healthcare facilities in low- and middle-income countries and related barriers and facilitators: a scoping review.Implementation science communications · 2026Pooled it
- Integration of Cardiovascular Disease Services within Primary Health Care Systems: Insights from South Asia.Current atherosclerosis reports · 2026Review
- Implementation research in Primary Care (Part 1): What is implementation research?Malaysian family physician : the official journal of the Academy of Family Physicians of Malaysia · 2026Review
- Continuity of care for people with hypertension in primary health care: a scoping review.Revista da Escola de Enfermagem da U S P · 2026Article
- Understanding the role and organization of health workers delivering non-communicable disease management in primary care in low- and middle-income countries: a scoping review.BMC primary care · 2025Article
- A Systematic Review of Continuity of Care Strategies for Enhancing Diabetes Self-Management in Older Adults in Asian Countries.Journal of multidisciplinary healthcare · 2025Review
- Article
- Self-Care Management, Patient Education, and Nursing Support in Patients with Diabetes and Hypertension.Galen medical journal · 2024Review
- 'Oxidative stress'-A new target in the management of diabetes mellitus.Journal of family medicine and primary care · 2023Review
- Developing an integrated model of care for vulnerable populations living with non-communicable diseases in Lebanon: an online theory of change workshop.Conflict and health · 2023Article
- Article
- Prevalence, Awareness, Treatment and Control of Diabetes in India From the Countrywide National NCD Monitoring Survey.Frontiers in public health · 2022Article
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Authors and funding
6 authors.
Funding
Abstract
backgroundChronic conditions are a leading cause of death and disability worldwide. Low-income and middle-income countries such as India bear a significant proportion of this global burden. Redesigning primary care from an acute-care model to a model that facilitates chronic care is a challenge and requires interventions at multiple levels.
objectivesIn this intervention study, we aimed to strengthen primary care for diabetes and hypertension at publicly funded primary healthcare centres (PHCs) in rural South India. DESIGN AND
methodsThe complexities of transforming the delivery of primary care motivated us to use a 'theory of change' approach to design, implement and evaluate the interventions. We used both quantitative and qualitative data collection methods. Data from patient records regarding processes of care, glycaemic and blood pressure control, interviews with patients, observations and field notes were used to analyse what changes occurred and why.
interventionsWe implemented the interventions for 9 months at three PHCs: (1) rationalise workflow to include essential tasks like counselling and measurement of blood pressure/blood glucose at each visit; (2) distribute clinical tasks among staff; (3) retain clinical records at the health facility and (4) capacity building of staff.
resultsWe found that interventions were implemented at all three PHCs for the first 4 months but did not continue at two of the PHCs. This fadeout was most likely the result of staff transfers and a doctor's reluctance to share tasks. The availability of an additional staff member in the role of a coordinator most likely influenced the relative success of implementation at one PHC.
conclusionThese findings draw attention to the need for building teams in primary care for managing chronic conditions. The role of a coordinator emerged as an important consideration, as did the need for a stable core of staff to provide continuity of care.
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