Authors (including presenting author) :
Hui SSC(1), Ko CF(2), Kong SK(3), Ng YW(1), Law WM(1), Law WC(1), Chung WW(1)
Affiliation :
(1)Specialist Outpatient Clinic, North Lantau Hospital (2)Medicine & Geriatric, Princess Margret Hospital and North Lantau Hospital (3)Specialist Outpatient Clinic, Princess Margret Hospital
Introduction :
Diabetes(DM)complications are major source of morbidity, mortality and economic impact to society. They also have great impact on social productivity and loss of quality of life. DM complications are preventable. The morbidity and mortality caused by poor controlled DM can be reduced by secondary prevention through regular screening, early detection, and appropriate treatments to reverse early complications and slow down deterioration. Besides, multidisciplinary DM education programs are important to empower DM patients on their DM self-care management skill.
Objectives :
1)Set up DMCS service based on “Metabolic Risk Assessment Module(MRAM)” standard in NLTH SOPC for the early detection of DM complications 2)Set up a multi-disciplinary empowerment program with podiatrist for education and consultation 3)Data entry to the MRAM for case doctor’s easy review of DM patients’ DM control parameters
Methodology :
DMCS service was set up in NLTH SOPC since August 2017. DM patients were referred by medical doctors for DMCS. DM background history, risk factors, physical measurements, foot sensation, vascular circulation were assessed. Direct referral to podiatrist was made for patients suffered from high/active foot risks. Examination data from DMCS, blood and urine testing results, eye examination reports were entered into the MRAM system in the CMS. Post-DMCS patients would attend a jointed program with podiatrist for report explanation, DM self-care management knowledge and skill empowerment. The suboptimal DM controls were highlighted in patients’ DMCS report copies for reference. Major DM complications were identified, and new referrals made for specialist consultation were collected and analyzed.
Result & Outcome :
DM patients could prevent DM complications only when they are adequately informed of their control parameters, rationale of the clinical interventions, empowered to carry out DM self-care management. DMCS service statistic(8/2017 - 12/2018): Total DMCS recruitment was 239, attendance was 223(93.3%); post-DMCS class recruitment was 186, attendance was 153(82.3%). Results showed: 44.4% of patient suffered from albuminuria; 57.8% of patient suffered from chronic kidney disease. 25.1% were attending regular eye follow-up. 74.9% didn't have regular eye check and eye need to be checked. Eye reports returned: 47.5% had cataract, 25.6% had retinopathy or maculopathy. New eye consultation referrals were made for 9.4% of returned eye reports. 83.0% of patient suffered from foot abnormalities, 11.7% need to be referred to podiatrist.