Page 220 - Hospital Authority Convention 2017
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Service Enhancement Presentations
      HOSPITAL AUTHORITY CONVENTION 2017


             F6.5      Enhancing Partnership with Patients and Community                10:45  Room 421

            Evaluation of a Targeted Intervention Programme for Patients with Diabetic-Kidney Disease
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            Loo KM , Law MC , Wong RYM , So TTY , Luk AOY , Fung J , Yau P , Kan I , Luk E , Fung B , Ho Z , Yeung THM , Chik MY ,
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            Choy WY , Lee KY , Chan WS , Lau LW , Chan JCN  3
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             Department of Medicine & Therapeutics, Prince of Wales Hospital,  Dietetics Department, Prince of Wales Hospital,  Faulty of
            Medicine, The Chinese University of Hong Kong, Hong Kong
            Introduction
            In Hong Kong, diabetes mellitus accounts for up to half of incident cases of renal replacement therapy. Besides having basic
            knowledge and skills on diabetes self-management, patients with diabetes complicated with diabetic kidney disease (DKD)
            should be well informed of their renal status and specifically, these patients should understand the clinical implications
            of DKD. It may include following renal diet, taking precautions to minimise the risks of worsening renal function, and be
            motivated to improve diabetes treatment targets in order to slow the progression of DKD and reduce cardiovascular risks.
            Objectives
            (1) To educate patients about clinical parameters related to renal function and to improve awareness of own risk factors; (2) to
            educate patients on renal precautions and self-management of DKD; and(3) to optimise glycaemic control.
            Methodology
            A joint programme organised by diabetes and renal nurse specialists, dietitians and endocrinologists was launched at the
            Diabetes and Endocrine Centre of Prince of Wales Hospital. Between October 2014 and December 2015, 90 patients with
            stage three or four chronic kidney disease (CKD) were recruited (male/female: 54/36, mean age 65.4± 6.0 years; CKD stage
            3/4: 59/26). In groups of 10, patients attended three 2.5-hour workshops followed by endocrinologist consultation quarterly
            over a one-year intervention period. The workshop empowered patients to understand their clinical condition, renal status
            and risk factors. We also included renal dietary principles and specific renal precautions. Peer sharing, discussion and
            experience exchange on self-management on different treatment modalities were promoted in the workshops.
            Results
            Upon completion of the programme, HbA1c was lowered by 0.3% compared with baseline. Patients rated a mean score
            of 5 out of 5 on improvement in knowledge on DKD management and they showed an appreciation on group discussion
            and sharing with a mean score of 4.97 out of 5. Among self-care behaviours, drug compliance, blood glucose monitoring
            and dietary control adherence were improved most with self-rated score of 4.96, 4.89 and 4.86 out of 5 respectively.  The
            programme set the framework and components to be included in education of patients with DKD. Feedback from participants
            was positive with overall improvement in knowledge and self-care management.




      Wednesday, 17 May



































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