Page 74 - Hospital Authority Convention 2017

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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