Lim Kean Ghee, Nantha Yogarabindranath Swarna, Kasim Nurfazila Hanim, Ramamoothy Tarshandiny, Yam Annabelle, Lim Ern Wei, Loh Matthew
Department of Surgery, International Medical University, Clinical Campus, Jalan Rasah, Seremban, Malaysia.
Klinik Kesihatan Seremban, Jalan Rasah, Seremban, Malaysia.
J ASEAN Fed Endocr Soc. 2019;34(1):56-61. doi: 10.15605/jafes.034.01.09. Epub 2019 Apr 5.
Medical students at the International Medical University (IMU), Seremban, Malaysia were required to assess patients at home over a period of two years as a part of their curriculum. The students conducted six visits to educate their patients and help them utilize available resources to manage their disease.This study aims to examine whether patients with diabetes visited improve their control of their disease, specifically in terms of their HbA1c measurement.
We used a retrospective, matched before and after study design to prevent biased levels of effort by students conducting the home visits over two years. Information was obtained through reports written by IMU students. Convenient sampling was used to select outpatients undergoing treatment 'as usual' from a health clinic and were subsequently matched as controls.
There was a significant decrease in the mean HbA1c among 57 patients with diabetes who were CFCS subjects [from 8.4% (68 mmol/mol) to 7.3% (57 mmol/mol) <0.001], while the mean HbA1c levels among 107 matched control subjects rose significantly from 7.9% (63 mmol/mol) to 8.3% (67 mmol/mol) (=0.019) over a similar period. The two groups were controlled for most biological and socioeconomic variables except for comorbidities, diabetic complications and medication dose changes between groups.
Behavioural intervention in the form of home visits conducted by medical students is an effective tool with a dual purpose, first as a student educational initiative, and second as a strategy to improve outcomes for patients with diabetes.
马来西亚芙蓉国际医学大学（IMU）的医学生在两年时间里需要在家中对患者进行评估，这是他们课程的一部分。学生们进行了六次家访，以教育患者并帮助他们利用可用资源来管理疾病。本研究旨在检验接受家访的糖尿病患者是否改善了对疾病的控制，特别是在糖化血红蛋白（HbA1c）测量方面。
我们采用回顾性、前后匹配的研究设计，以防止进行家访的学生投入程度存在偏差。信息通过IMU学生撰写的报告获取。采用便利抽样法从一家健康诊所中选取“常规”接受治疗的门诊患者，随后将其作为对照进行匹配。
57名作为社区家庭访视护理服务（CFCS）对象的糖尿病患者的平均HbA1c显著下降[从8.4%（68 mmol/mol）降至7.3%（57 mmol/mol），P<0.001]，而在同一时期，107名匹配对照对象的平均HbA1c水平从7.9%（63 mmol/mol）显著升至8.3%（67 mmol/mol）（P=0.019）。除了合并症、糖尿病并发症以及两组之间的药物剂量变化外，两组在大多数生物学和社会经济变量方面得到了控制。
医学生进行家访形式的行为干预是一种有效的工具，具有双重目的，一是作为学生教育举措，二是作为改善糖尿病患者治疗效果的策略。
