Aim: To study the effect of customized care consultations on glycaemic control for older adults with diabetes in Hong Kong. Method: The study was conducted in 2009 for clients of the PolyU-Henry G. Leong Mobile Integrative Health Centre (MIHC). Out of the 1792 clients, 303 (16.9) with self-reported diabetes were recruited on voluntary basis. Information related to their medical history, diabetic education literacy, diet and exercise habit was collected. Furthermore, 84 (27.7%) of those with high blood glucose or sub-optimal glycaemic control were referred to receive customized diabetes care consultations where in-depth assessment and education, and lifestyle modification intervention were provided. They were identified if the spot blood glucose test showed a concentration of 11mmol/L or higher. Individual consultation sessions on patient-specific education and skills training for lifestyle modification were provided. Each client received 4 to 6 sessions on average. The outcome measure of patients’ adherence was based on pre-post test on spot blood glucose level and behavioural change. Results: A total of 191 (63%) female and 112 (37%) male diabetes were recruited. 84 of them (60.7% were female) were then referred for customized care consultation. Their age range was from 70 to 79 years old. One dropped out of the survey. The treatment modalities that they had been receiving included diet control (22.6%), medication (66.7%) and insulin therapy (9.5%). After the intervention of customized consultations, nearly half of them (45.2%) were found to have improved their glycaemic control through better diet adherence, established regular exercise, improved drug compliance, established self monitoring and resumed regular medical follow up. However, 14.3% exhibited poor control, which was due to weak motivation in maintaining diet adherence and drug compliance, and failure to seek medical follow up or diabetes care consultation. Conclusion: The customized consultation sessions were found to be beneficial to assist older adults to maintain optimal glycaemic control, where customized health care education and lifestyle modification play a key role. It is thus advisable to promote such service in the community.
|Publication status||Published - 2011|