Authors (including presenting author) :
Chan YK (1), Hung SCV (1), Chow MF (1), Siu SM (1), Phoebe Wong (2), To CH (1)(3), Lui CT (3), Wun YC (3), Wong WK (4), Queenie Leung (5)
Affiliation :
(1) Department of Medicine & Geriatrics, Tin Shui Wai Hospital (2) Patient Resources Centre, Tin Shui Wai Hospital (3) NTWC Smart Hospital Program Committee (4) Special Outpatient Clinic, Tin Shui Wai Hospital (5) Nursing Service Division, NTWC
Introduction :
Diabetes Mellitus is a chronic disease and regular follow-up is essential to monitor the progress of the disease. Telemetric interventions have attracted great interest and may provide practical new therapeutic approaches for improving the management of Diabetes Mellitus.
Objectives :
To evaluate the clinical benefits and patient satisfaction of a Telehealth Nurse-led Clinic (Diabetes) at Tin Shui Wai Hospital (TSWH) using the HA Go App.
Methodology :
Patients attending regular follow-up visits to TSWH conventional diabetes nurse-led clinic were recruited. The patients were scheduled to meet the diabetes nurse via HA Go App. The inclusion criteria were age >18, Chinese ethnicity, a hemoglobin A1c (HbA1c) >7.0%, and no previous telemedicine experience. Exclusion criteria included patients with cognitive deficits, communication barriers, and recent hospitalization within one year. Verbal consent was obtained, and an information sheet about Telehealth was given to patients. Three virtual follow-up visits were offered by the diabetes nurse once every six weeks. Patients were given individualized advice on diet, exercise, drug adherence, and glycemic control. The clinical characteristics of the Tele Nurse-Led Clinic group were compared with the conventional group (those who had in-person traditional clinic visits). The control subjects were matched by age (same year of birth), sex, and HbA1c. Blood tests, including HbA1c and lipid profile, were taken at the last physical visit before study entry and after the three virtual follow-up visits. The changes in HbA1c and lipid profile were analyzed by independent t-test. A survey on patient satisfaction was distributed to study group participants after teleconsultation. The satisfaction was measured using a Likert Scale with scores rating from 1 to 5 (1= “strongly disagree” and 5 = “strongly agree”). In addition, the default rate of the Tele Nurse-Led Clinic group and the conventional group were recorded.
Result & Outcome :
From July 2021 to June 2022, 84 patients (64.3% female) were included in this study. Half of the participants were in the Tele Nurse-Led Clinic group; another half were in the conventional group. The results in the two groups were compared after six months of intervention. There were no significant differences in the HbA1c (7.18% vs. 7.43%, p= 0.320), cholesterol (3.95mmol/L vs. 3.98 mmol/L, p= 0.854), HDL (1.22 mmol/L vs. 1.12 mmol/L, p= 0.874), LDL (2.08 mmol/L vs. 2.04 mmol/L, p= 0.835) and TG (1.40 vs. 1.62 mmol/L, p= 0.253) between the two groups. Regarding patient satisfaction, the median score was 5, indicating an overall satisfactory patient experience in communication and rapport building with diabetes nurses. In addition, all patients attended the consultations in the telehealth group, whereas 13.7% of visits in the conventional group were defaulted. This demonstrates that a Tele-Nurse-Led clinic model via HA Go App offers a more convenient patient experience in diabetes care compared to face-to-face care visits. Conclusion Diabetes Tele-Nurse-Led clinic via HA Go App could be integrated into diabetic care as an effective alternative to conventional in-person care visits in improving the management of Diabetes Mellitus.
