Authors (including presenting author) :
Lau SWM (1), Chien WT (2), Tam YK (1), Lee SWJ (1), Tsang CC (1)
Affiliation :
(1)Diabetes & Endocrine Centre, Department of Medicine, Alice Ho Miu Ling Nethersole Hospital, (2) Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong
Introduction :
Diabetes Mellitus is a progressive metabolic disease and necessitates continuous medical management and self-care education to prevent or delay acute or chronic complications. According to Hospital Authority (HA) report in 2021, the waiting time for ‘stable’ new cases to book first medical appointments in specialist out-patient clinic (SOPC) from 1 July 2020 to 30 June 2021 was in a median of 88 weeks and the longest 134 weeks. Most patients with type 2 diabetes (T2DM) are having suboptimal glycaemic control, co-morbidities such as retinopathy and renal impairment at referrals and require earlier medical treatment and attention.
Objectives :
A controlled trial was to examine the effectiveness of a pre-medical consultation online diabetes self-care education program for patients with T2DM on glycemic control and diabetes self-care from 03/06/2019 to 31/03/2021. A total of 48 Chinese patients with T2DM were recruited from the SOPCs of Alice Ho Miu Ling Nethersole Hospital and Prince of Wales Hospital. The primary outcome was Haemoglobin A1c (HbA1c) and secondary outcomes were Diabetes Management Self-Efficacy Scale (DMSES) and Diabetes Empowerment Scale (DES).
Methodology :
Patients in the intervention group received three online self-care education sessions for reinforcement on diabetes self-care management at weeks 4, 8 and 12. At weeks 16 to 20, the patients were also contacted via phone by the intervener twice to reinforce their diabetes self-care. At weeks 12 (T1) and 20 (T2), both patients in the intervention and control groups returned to take blood for HbA1c and complete questionnaires (DMSES and DES).
Result & Outcome :
All quantitative data were analysed by using the IBM SPSS, version 27. Mean age of the 48 participants was around 58 (Intervention group: 58.6 ± 9.9 and Control group: 57.5 ± 9.2); and more than half (58.3%) were males. At baseline, the glycaemic control (HbA1c level) in the intervention group was 8.5 ± 1.2 versus 8.7 ± 1.4 in the controls. There were no significant differences on all socio-demographic and clinical characteristics between the two groups. Results of Generalized estimating equations (GEE) test followed by contrasts tests indicated statistically significant greater improvements in diabetes empowerment score at both T1 ( p = 0.035) and T2 (p = 0.003), when compared with the control group.
The results of this pilot study signified an effective and inexpensive diabetes self-care programme on diabetes empowerment for patients with T2DM before their first medical appointment at SOPCs. Moreover, this programme provide timely diabetes self-care knowledge and skills for these out-patients. (word count: 399)
