Browsing by Author "Thakur, Chanda"
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Publication Effectiveness of Structured Counseling Program for Patients with Newly Diagnosed Essential Hypertension(Nepal Health Research Council, 2024) Shrestha, Anmol Purna; Shrestha, Abha; Shrestha, Roshana; Karmacharya, Robin Man; Thakur, Chanda; Shrestha, Rashmi; Vaidya, Nirish; Karmacharya, Biraj ManBackground: The burden of hypertension is high in our context. Poor adherence contributes to poor hypertension control. This pilot study aims to study the effect of structured counseling programs on antihypertensive therapy adherence and blood pressure control. Methods: This is an effectiveness-implementation hybrid design type I- Quasi-experimental feasibility study. We recruited newly diagnosed hypertensive patients under antihypertensives with 50 each in the intervention and control group. We adapted existing guidelines to devise a structured counseling program. The intervention group underwent the counseling program. We called both groups after one month to assess the adherence and blood pressure control. Results: We recruited 100 newly diagnosed hypertensive patients. Twenty-two participants dropped out in the one-month follow-up visit. Among the remaining 78 individuals, 73 (94%) demonstrated good adherence. The post-intervention median (IQR) of medication adherence scores assessed with the Medication Adherence and Report Scale (MARS) in the intervention and control groups after one month was 50 (48-50) and 48 (43.5-50) respectively (p=0.015). The immediate knowledge score increased significantly in the intervention group after the structured counseling. Nevertheless, there was no significant change in systolic and diastolic pressure recordings in the intervention group one-month post-intervention when compared to that of the control group. Conclusions: The findings of this pilot study suggest that the structured counseling program should be tailored to local needs and should be compounded with regular follow-ups for reinforcement, drug reminders, and family and peer support along with a collaborative effort to ensure adherence and control. Keywords: Adherence; antihypertensive; hypertension management; structured counseling.Publication Evaluation of Self-vision Assessment Charts in Schools of Eastern Nepal: A Multi Method Study(Nepal Medical Association, 2024) Shrestha, Archana; Thakur, Sudhir Kumar; Roshan, Abhishek; Singh, Sanjay Kumar; Pokhrel, Archana; Bohara, Apekshya; Poudel, Lisasha; Thakur, Chanda; Adhikari, Asmita; Timsina, Priyanka; Acharya, Yunika; Karn, Rajiv RanjanAbstract Introduction: Globally, over two billion people suffer from vision impairment, almost half preventable. In Nepal, the Eastern Regional Eye Care Program introduced self-vision assessment charts in 137 schools for early eye issue detection. This study assessed the charts' use and perceived impact. Methods: A multi-method study was conducted to evaluate the use of self-vision assessment charts in schools in Eastern Nepal. Ethical approval was obtained from Institutional Review Board (Refrence number: 72-079-040). Quantitative data were collected through a questionnaire survey. Quantitative data were analyzed using descriptive statistics, while qualitative data were analyzed using framework analysis. Both methods were integrated to enhance understanding of participants' experiences. Results: In this study, 400 students participated in questionnaire survey, 180 in self vision assessment, and 16 teachers in in-depth interviews. Among the participants, 198 (49.50%) of students used the chart, 125 (65.78%) expressed satisfaction, 241 (60.25%) found it useful, 276 (69%) as beneficial, and 253 (63.25%) stated improved health. There were 93 (23.25%) students who felt knowledgeable about its use, with 18 (10%) using it correctly. In 162 (90%) of schools there were adequate chart placement, 23 (12.77%) provided clear signage for viewing points. Teachers recognized the chart's benefits and encouraged its use, but students lacked awareness. Regular use was viewed as beneficial for early detection of eye issues, though challenges included a need for more awareness among students and teachers and reliance on home remedies. Conclusions: Most students and teachers acknowledged self-vision assessment charts’ benefits but had low utilization and accuracy rates. Strategic interventions such as regular informational sessions, teacher motivation, and engagement with eye health experts are essential.