Authors (including presenting author) :
HUNG SY, CHENG YH, MAK KY, Winky LEUNG YN, Wangie LEUNG WC, Vienna LEUNG CW, CHEUNG PH, Annow CHOW WP, Kathy CHEUNG YH, Marcus WONG MS, Michelle WONG MY
Affiliation :
Department of Family Medicine and Primary Healthcare, Hong Kong East Cluster, Hospital Authority (HA)
Introduction :
Hemoglobin A1c (HbA1c) is the average amount of glucose attached to hemoglobin over the past three months. The American Diabetes Association recommends maintaining A1C levels below 7 % for most people, it can delay or prevent complications.
In Chai Wan General Out-patient clinic (CW GOPC), there are around 3800 Diabetes (DM) patients, around 930 of them had sub-optimal HbA1c ranging from 7-7.5%. With an increasing DM population, complication screening would be arranged every 2 to 3 years; although nurse education and referral to allied health team (e.g. Dietitian) was provided; regimen adherence problems are common, making glycemic control difficult to attain and sustain.
Objectives :
1. Improve sub-optimal Diabetes control of patients
2. Provide education and intervention to patients
3. Facilitate doctor consultation process
Methodology :
Nurses screened out DM patients who followed up in CW GOPC with age ≤ 75 and HbA1c 7%-7.5%. Before doctor consultation, brief intervention of about 5-10 minutes was given: informed the recent HbA1c result, explained relationship of HbA1c with DM complications and target HbA1c; checked drug compliance and lifestyle adherence. After that, brief education would be provided. For patients who refused DM drug titration before, nurse would ask for their willingness to titrate.
A reminder would be given to case doctor about patients’ problem and education provided. Case doctor would prescribe Hba1c test before next follow up.
Result & Outcome :
From 18 Nov 2019 to 23 Feb 2020, 70 patients were recruited by convenient sampling. 87.1 % had fair diet control, 81.43% did not have enough physical activities and 17.12% had fair drug compliance.
Among 70 subjects, 43 patients (61.43%) showed the decreased levels of HbA1c after 3 months. 31(44.29%) patients had HbA1c values less than 7%.
Among the 43 patients above, 21 (48.84%) of them improved HbA1c without DM medication titration.
