Authors (including presenting author) :
Tong MH, Wong KM, Lam FY, Chim CK
Affiliation :
Community Outreach Services Team(COST), New Territories East Cluster(NTEC)
Introduction :
Using advance technological device for early detection of exacerbation and hypoglycaemia with timely intervention can reduce hospital admission and improve health status. Thus, NTEC COST implemented two projects of using smart devices to support high-risk elderly with DM or COPD since August 2020.
Objectives :
1. To detect early signs of COPD exacerbation or unawared hypoglycaemia
2. To prevent avoidable emergency admission
3. To empower patients’ self-management
Methodology :
In August 2020, Flash glucose monitoring(FGM) program was implemented for DM patients. The device could monitor patient’s glucose profile for 14 days to detect unawared hypoglycaemia.
In November 2021, “O2 ring” program was initiated for COPD patients. Patients wore O2 ring at least 5 days. It aimed to detect SpO2 pattern and early signs of exacerbation.
Nurses could retrieve glucose/ SPO2 profile via mobile apps at home. Thus, timely interventions could be provided accordingly.
Pre-post empowerment score regarding patient self-management skill on the diseases were evaluated. Staff and patient satisfaction surveys were conducted.
Result & Outcome :
For FGM, 65 patients were recruited with mean age 76.83. 519episodes of hypoglycaemia were detected, 60%(n=311) occurred at midnight. 58.5%(n=38) patients required drug titration. 92.3% (n=60) required lifestyle modification. Mean DM empowerment score increased from 13.39 to 17.76
For O2 ring, 5 patients were recruited with mean age 80.8. 4 patients and 1 patient showed exertional desaturation and nocturnal desaturation respectively. 100%(n=5) required puff regime adjustment. 1 patient required medical consultation. Post CAT mean score reduced from 17.25to 12. Mean COPD empowerment score increased from 14.75 to 16.75
98.5%(n=64) and 100%(n=5) had no emergency admission within 28 days in FGM and COPD program respectively. Satisfaction survey 98%(n=61)patients agreed programs enhanced their self-management skill and awareness on disease status. All staff(n=60) agreed the devices were easy to use, facilitate patient care and recommend for further use in clinical care.
Conclusion
Both programs demonstrated promising result in using smart devices to detect the exacerbation symptoms which cannot be achieved in conventional practice. It paved a milestone to deliver patient care in smart technology for high-risk elderly.
