Table 3 Outcomes and data sources
Outcome | Description and data sources |
|---|---|
Primary outcomes | |
Feasibility | FIM questionnaires and MOH data from DHIS2 (quantitative); semi-structured interviews with MOH participants (qualitative) |
Acceptability | AIM questionnaires and MOH data from DHIS2 (quantitative); semi-structured interviews with patient and MOH participants (qualitative) |
Secondary outcomes | |
Clinical outcomes | |
Number of patients receiving hypertension medication treatment per month (“hypertension treatment rate”) | MOH data from SIGSA (quantitative) |
Number of patients receiving diabetes medication treatment per month (“diabetes treatment rate”) | MOH data from SIGSA (quantitative) |
Proportion achieving glycemic control (FBG < 115 mg/dl or RBG < 160 mg/dl) among patients with diabetes | MOH data from DHIS2 (quantitative) |
Proportion achieving control of blood pressure (< 130/80 mmHg) among patients with hypertension | MOH data from DHIS2 (quantitative) |
Number of patients receiving hypertension medication treatment per month (“hypertension treatment rate”) | MOH data from SIGSA (quantitative) |
Implementation outcomes | |
Adoption | Number of participating health facilities, defined as having enrolled at least one patient with hypertension or diabetes (quantitative); reasons for variation (qualitative) |
Fidelity (health worker training on hypertension and diabetes treatment protocols) | Proportion of health workers in each district attending all training sessions, chart audit of prescriptions to assess guideline concordance (quantitative); reasons for variation (qualitative) |
Fidelity (team-based care and task sharing) | Proportion of primary health districts conducting at least one care coordination meeting; reasons for variation (qualitative) |
Fidelity (access to medicines and diagnostics) | Monthly availability of MOH medications and diagnostics (quantitative) and reasons for variation (qualitative) |
Fidelity (facility-based electronic monitoring tool) | Proportion of patient visits captured in DHIS2 each month compared to comprehensive records in SIGSA (quantitative) and reasons for variation (qualitative) |
Fidelity (systems monitoring and feedback) | Proportion of quarterly reports viewed by health district administrators (quantitative) and reasons for variation (qualitative) |
Usability (facility-based electronic monitoring tool) | System Usability Scale [48, 49] (quantitative) and reasons for variation (qualitative) |
Sustainability | Program Sustainability Assessment Tool [50, 51] and Clinical Sustainability Assessment Tool [52, 53] (select questions) |
Patient-related outcomes measures | |
Diabetes distress | Diabetes Distress Scale [54, 55], 2-item screening and physician distress subscale |
Disability | WHO Disability Assessment Schedule [56] |
Multimorbidity treatment burden | Multimorbidity Illness Perceptions Scale [57, 58], treatment burden subscale |