Implementation strategies for providing optimised tuberculosis and diabetes integrated care in LMICs (POTENTIAL):...

Area of Science:

• Public Health
• Infectious Diseases
• Endocrinology

Background:

• High prevalence of diabetes and pre-diabetes among tuberculosis (TB) patients in Pakistan.
• Diabetes exacerbates TB outcomes and increases disease burden.
• Need for integrated care strategies to manage co-existing TB and diabetes.

Purpose of the Study:

• To design and implement an optimized tuberculosis-diabetes care package (Opt-TBD).
• To pilot, refine, and evaluate the Opt-TBD package in Pakistani TB care facilities.
• To improve health, quality of life, and economic outcomes for patients with co-occurring TB and diabetes.

Main Methods:

• Multiphase mixed-method study in Khyber Pakhtunkhwa and Punjab, Pakistan.
• Development and piloting of the integrated Opt-TBD care package and implementation strategies.
• Evaluation using Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework, with quantitative and qualitative data analysis.

Main Results:

• The study will assess provider adoption and patient accessibility and effectiveness of the Opt-TBD package.
• Qualitative data will identify barriers and facilitators for implementation and scale-up.
• Quantitative data analysis will include descriptive and inferential statistics; qualitative data will use framework analysis.

Conclusions:

• The integrated Opt-TBD care package aims to optimize management of co-existing TB and diabetes.
• Successful implementation and evaluation are expected to improve patient outcomes and reduce disease burden.
• Findings will inform potential scale-up of the integrated care model in Pakistan.