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

<h2>Abstract</h2><h3>Background</h3> 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. <h3>Methods</h3> 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. <h3>Results</h3> 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. <h3>Conclusion</h3> 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.