Page 134 - Hospital Authority Convention 2017

Service Enhancement Presentations
HOSPITAL AUTHORITY CONVENTION 2017

F3.2 Clinical Safety and Quality Service I 14:30 Room 421

Multi-centre Project for the Evaluation of the Effectiveness of Diabetes Nurse Clinic on Patients with Newly
Diagnosed Type 2 Diabetes Mellitus
1
2
3
Cheng MWW , Hung SCV , Kwan YMJ , Leung LYE 4
2
3
1 Department of Medicine, Queen Elizabeth Hospital, Department of Medicine, Tuen Mun Hospital, Department of Medicine,
4
Our Lady of Maryknoll Hospital, Department of Medicine, Queen Mary Hospital, Hong Kong
Introduction
Diabetes mellitus (DM) is a chronic disease that relies on patients’ day-to-day self-care to achieve good glycaemic control
so as to reduce the risk of developing diabetes-related complications and healthcare burden. In Hong Kong, Diabetes Nurse
Clinics (DMNC) is established at seven clusters of Hospital Authority to manage and empower diabetes patients.
Objectives
To evaluate the effectiveness of DMNC in empowering newly diagnosed type 2 diabetes’ self-care efficacy.

Methodology
A multicentre project was conducted during the period from November 2014 to June 2015 to evaluate the effectiveness
DMNC. Patients diagnosed type 2 DM within two year, able to understand Chinese, and not on insulin therapy were recruited
Tuesday, 16 May Education (DSME) programme either individually or in small group stressing importance of diabetic control, ways to achieve
from five hospitals, including Our Lady of Maryknoll Hospital (OLMH), Tuen Mun Hospital (TMH), Pok Oi Hospital (POH),
Queen Elizabeth Hospital (QEH) and Queen Mary Hospital (QMH). They were allocated to Diabetes Self-Management
good diabetic control by understanding oral anti-diabetic medications, healthy diet, regular exercise, blood glucose
monitoring, hypoglycaemia management and foot care knowledge.

Outcome measurements included glycated hemoglobin (HbA1c), lipid profiles, body mass index (BMI), and two validated
scales “Summary of Diabetes Self-Care Activities” (SDSCA) and “Diabetes Knowledge” (CKDN).

Results
113 patients were recruited, 70 patients (61.9%) were male, 43 (38.1%) were female. Age ranged from 21 to 83 years old (mean
54.9 + 11). More than 50% were working class, 88 (77%) have secondary education level and 14 (12.4%) were smoker. 76
patients (69.1%) were on oral anti-diabetic medications at recruitment.

Pre- and post-intervention evaluation showed significant improvement in glycaemic control with mean HbA1c from 7.89 to
6.89% (p= 0.000); LDL-cholesterol from 2.75 to 2.43 mmol/L (p=0.000); total cholesterol from 4.84 to 4.37 mmol/L (p=0.000).
CKDN showed that subjects had significant improvement in DM knowledge from 5.4 + 2.5 to 6.7 + 1.6 (p<0.00); SDSCA also
showed significant improvement in following healthy diet (p=0.000); regular exercise (p=0.000); self-monitoring of blood
glucose (p=0.010) and foot care (p=0.000).

DM Nurse Clinic is effective in improving glycaemic and lipid control through empowering newly diagnosed type 2 diabetic
patients on self-care knowledge and behaviour change. And it is suggested to conduct the project with longer duration so as
to assess its efficacy on long-term effects in maintaining healthy lifestyles, reducing both metabolic and cardiovascular risk
factors.

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