Madavanakadu Devassy Saju, Baby John Salini, Scaria Lorane
Department of Social Work, Rajagiri College of Social Sciences, Kalamassery, Cochin, Kerala, India.
International Centre for Consortium Research in Social Care, Kalamassery, Cochin, Kerala, India.
Prev Med Rep. 2023 Nov 8;36:102495. doi: 10.1016/j.pmedr.2023.102495. eCollection 2023 Dec.
Uncontrolled hypertension and diabetes are a challenge for healthcare providers worldwide. The research documenting the underlying risk factors of uncontrolled chronic illnesses in community cohorts from India is negligible. The current cross-sectional household door-knock survey conducted among 759 participants aged 30 and above from a geographically well-defined area examines the cognitive risk factors associated with hypertension and diabetes control in the Indian population. The study used an assessment tool consisting of a socio-demographic questionnaire, items to measure cognitive factors, and onsite hypertension and diabetes measurements. Results suggested that among the participants, more than 36% had hypertension, 26% had diabetes, and of those with diagnosed diabetes and hypertension, more than 22% with hypertension and 48% with diabetes had uncontrolled conditions. Univariate analysis suggests that cognitive functioning was negatively associated with uncontrolled hypertension and psychological impairments of depression and anxiety were positively associated. The associations were not significant for uncontrolled diabetes. Only if treatments integrate psychological and cognitive interventions to ensure adherence to medical and lifestyle modifications will it achieve the WHO target of 80% control of detected conditions. The findings can inform the policies and programs to optimise government spending and modify the current chronic condition management practices.
未控制的高血压和糖尿病对全球医疗服务提供者来说都是一项挑战。关于印度社区队列中未控制的慢性病潜在风险因素的研究微乎其微。目前在一个地理边界明确地区对759名30岁及以上参与者进行的横断面挨家挨户调查，考察了印度人群中与高血压和糖尿病控制相关的认知风险因素。该研究使用了一种评估工具，包括一份社会人口统计学调查问卷、测量认知因素的项目，以及现场高血压和糖尿病测量。结果显示，参与者中超过36%患有高血压，26%患有糖尿病，在已确诊糖尿病和高血压的患者中，超过22%的高血压患者和48%的糖尿病患者病情未得到控制。单因素分析表明，认知功能与未控制的高血压呈负相关，而抑郁和焦虑等心理障碍与之呈正相关。这些关联在未控制的糖尿病方面并不显著。只有当治疗整合心理和认知干预以确保坚持医疗和生活方式改变时，才能实现世界卫生组织80%已检测病情得到控制的目标。这些研究结果可为优化政府支出的政策和项目提供参考，并改进当前慢性病管理实践。
