TY - JOUR T1 - EXTending availability of self-management structured EducatioN programmes for people with type 2 Diabetes in low-to-middle income countries (EXTEND)—a feasibility study in Mozambique and Malawi JF - BMJ Open JO - BMJ Open DO - 10.1136/bmjopen-2020-047425 VL - 11 IS - 9 SP - e047425 AU - Emer M Brady AU - The EXTEND Collaborative AU - Catherine Bamuya AU - David Beran AU - Jorge Correia AU - Amelia Crampin AU - Albertino Damasceno AU - Melanie J Davies AU - M Hadjiconstantinou AU - Deirdre Harrington AU - Kamlesh Khunti AU - Naomi Levitt AU - Ana Magaia AU - Jayna Mistry AU - Hazel Namadingo AU - Anne Rodgers AU - Sally Schreder AU - Leopoldo Simango AU - Bernie Stribling AU - Cheryl Taylor AU - Ghazala Waheed Y1 - 2021/09/01 UR - http://bmjopen.bmj.com/content/11/9/e047425.abstract N2 - Background Globally, there are estimated 425 million people with type 2 diabetes (T2D) with 80% from low-middle income countries (LMIC). Diabetes self-management education (DSME) programmes are a vital and core component of the treatment pathway for T2D. Despite LMIC being disproportionally affected by T2D, there are no DSME available that meet international diabetes federation criterion.Methods The aims were to test the feasibility of delivering a proven effective and cost-effective approach used in a UK population in two urban settings in Malawi and Mozambique by; (1) developing a culturally, contextually and linguistically adapted DSME, the EXTending availability of self-management structured EducatioN programmes for people with type 2 Diabetes in low-to-middle income countries (EXTEND) programme; (2) using a mixed-method approach to evaluate the delivery of training and the EXTEND programme to patients with T2D.Results Twelve healthcare professionals were trained. Ninety-eight participants received the DSME. Retention was high (100% in Mozambique and 94% in Malawi). At 6 months HbA1c (−0.9%), cholesterol (−0.3 mmol/L), blood pressure (−5.9 mm Hg systolic and −6.1 mm Hg diastolic) improved in addition to indicators of well-being (problem areas in diabetes and self-efficacy in diabetes).Conclusion It is feasible to deliver and evaluate the effectiveness of a culturally, contextually and linguistically adapted EXTEND programme in two LMIC. The DSME was acceptable with positive biomedical and psychological outcomes but requires formal testing with cost-effectiveness. Challenges exist in scaling up such an approach in health systems that do not have resources to address the challenge of diabetes.No data are available. The authors confirm that the data supporting the findings of this study are available within the article and its supplementary materials. Raw data that support the findings of this study are available from the corresponding author (EMB, MJD) upon reasonable request. ER -