Nursing Intervention to improve lipid profile of Diabetes Mellitus patients who have been on statin

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Authors (including presenting author) :
Cheng YH, Hung SY, Cheung WY, Kong CW, Lau PY, Lam MY, Annette Lam KK, Cheung PH, Annow, Chow WP, Kathy Cheung YH, Marcus Wong MS, Michelle Wong MY
Affiliation :
Family Medicine and Primary Healthcare, Hong Kong East Cluster, Hospital Authority (HA)
Introduction :
Dyslipidemia is one of the major risk factors for cardiovascular disease in diabetes mellitus (DM). Non-compliance of medication therapy and lifestyle modification are common problems that leads to compromised health benefits and serious economic consequences in terms of wasted time, money and uncured disease. Health education is indispensable in achieving individual and community health. It can help to increase knowledge and to reinforce desired behaviour patterns.
Objectives :
-To clarify health misconceptions regarding treatment -To reinforce patients’ to have positive lifestyle
Methodology :
DM patients who have already on statin for over one year with abnormal lipid profile (LDL-Cholesterol ≥2.6 mmol/L , HDL-Cholesterol ≤1.0 mmol/L for male, ≤1.3 mmol/L for female , Triglyceride ≥1.7 mmol/L) were recruited to this program by convenience sampling. Nurses checked patients’ drug compliance by drug samples book. 20 minutes health education related to lipid control with standard educational material and content (relationship of DM and cholesterol, importance of lifestyle modification, e.g. diet, exercise etc…) was provided. An new education leaflet was designed and given to patients. Phone follow up were provided on week 1 and 3 months. Patients’ drug compliance, lifestyle modification and clarification of health misconception were checked by nurse during phone follow up.. Pre and post questionnaires were compared.
Result & Outcome :
From May 2018 to July 2018, 33 patients were recruited. The duration of having statin treatment were ranging from: 40% on statin for 3 to 5 years, 36% on statin for 6 years, 24% on statin for 1-2 years. It was found that 18% of patients had drug compliance problem. Among the 18%, 37% told that they always forgot to take statin; 25 % expressed that they were afraid the side effect of statin. After Nursing education and phone follow up, drug compliance rate was improved from 82% to 100%. There was also improvement of regular exercise habit, increased from 70% to 88%. More patients started to use healthy cooking method, the rate was increased from 63.5% to 71 %. Dyslipidaemia is one of the major risk factors for diabetes macrovascular complications. Understanding the reason of non-drug compliance is importance. Nursing intervention can improve patients’ drug compliance, enhance positive lifestyle modification and provide clarification of misconception.

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