Effect of a community-based health behaviour intervention on health-related quality of life in people with type 2 diabetes in Nepal: a cluster randomized controlled trial

Title : Effect of a community-based health behaviour intervention on health-related quality of life in people with type 2 diabetes in Nepal: a cluster randomized controlled trial

Abstract:

Community-based health behaviour interventions are effective in Type 2 diabetes (T2DM) management; however, little is known about their effectiveness in improving health-related quality of life (HRQOL). We examined the effectiveness of a culturally appropriate health behavioural intervention in improving HRQOL of people with T2DM in Nepal. A cluster randomized controlled trial was conducted among 481 people with T2DM from 30 randomly selected healthcare facilities in Kavrepalanchok and Nuwakot districts. The intervention group received 12 culturally-tailored and group-based intervention sessions for six months through community health workers and peer supporters whereas, the control group received usual care. The primary outcomes of this study were changes in EuroQOL (EQ5D-3L) index score and EuroQOL visual analogue scale (EQVAS) score between baseline and six-month post-intervention. The intervention effect was assessed using generalized estimating equation models. At six-months post-intervention, there was a positive and statistically significant effect on EQVAS score (β1=3.61, 95%CI: 0.05, 7.17) in the intervention group compared to control group. No statistically significant effect was observed in the EQ5D-3L index score. A statistically significant increase in EQVAS score of 0.5 was observed per session attended by the study participants (β1=0.49, 95%CI: 0.01, 0.98). The health behaviour intervention led to an improvement in HRQOL. An increase in the number of intervention sessions attended was significantly associated with higher EQVAS scores, emphasizing the need for longer-term and engaging interventions that are well adhered too. Longer term assessment of change in HRQOL outcomes are needed when actual changes in HRQOL are more likely to be observed.

Keywords: Health-related quality of life; Type 2 diabetes, EuroQOL, EQ5D

Biography:

Karki A is a third year PhD candidate with extensive experience in chronic disease research and is passionate about improving the health and well-being of people by translating research into practice. She has contributed significantly to the design, data management, intervention implementation, findings dissemination and overall coordination of the above cluster RCT conducted in Nepal. She has coordinated other trials such as the Very-low Energy Diet and Lifestyle Intervention among Aboriginal Australians, Online Grocery Shopping Clinical Trial in Australia; projects like Nepal Non-communicable Diseases and Injury Poverty Commission of the Lancet NCDI commission; and supported numerous health projects in Nepal and Australia in various capacities. She has authored multiple journal articles from her research engagement.