Mbale

Researchers are conducting a multinational, prospective observational study called the ICU-related Out-of-Pocket Expenses (ICOPE) study in African and Asian countries. This study aims to measure the financial burden on patients and families related to ICU care, focusing on out-of-pocket expenses and catastrophic health expenditure. The study includes both ventilated and non-ventilated patients admitted to participating ICUs during a 14-day recruitment period, with a planned sample size of at least 354 patients. Participants are followed during their ICU stay, which averages about 7 days, and additional follow-ups occur at 30 days and 6 months after admission. The study compares costs between patients receiving invasive mechanical ventilation and those who are not ventilated. It also investigates risk factors for catastrophic health expenditure and documents how families cope with the financial demands of ICU care. Throughout the study, researchers collect data on patient expenses, including direct medical and non-medical costs, as well as indirect costs such as income loss. The main outcomes measured are the out-of-pocket cost per patient episode until ICU discharge and the relative risk of catastrophic health expenditure. The total study duration spans 18 months, allowing for comprehensive assessment of financial impact and coping strategies over time.

Researchers are evaluating a digital-first, multi-component care strategy to improve self-care for patients with Heart Failure (HF) at six Regional Referral Hospital outpatient departments in Uganda. This stepped wedge, cluster-randomized trial will assess both implementation and clinical outcomes, including the effectiveness of an enhanced standard-of-care clinical bundle and a digital health intervention called Medly Uganda. The study focuses on improving HF self-care and reducing mortality and hospitalization rates over time. The study involves training healthcare providers in an enhanced HF clinical care bundle (Core-HF) that includes a treatment protocol, patient and provider self-care training, and medication stock management. After this, the digital health intervention Medly Uganda will be introduced, offering a mobile app for patients to report symptoms and receive self-care guidance, alongside a clinician dashboard for monitoring and nurse-guided management. This phased approach supports standardized care and digital monitoring for better management of HF. Participants will be assessed regularly at baseline and every six months up to 36 months for self-care using the Self-Care of Heart Failure Index and clinical effectiveness including mortality and hospitalizations. The study will also collect qualitative and quantitative data to guide ongoing improvements. Patients must have access to a mobile phone and basic reading skills in specific local languages or English. Continuous monitoring and evaluation throughout the study aim to optimize care delivery and patient outcomes in this setting.