Designing Tailor-made Interventions for Patients with Diabetes at Setthathirat Hospital, Lao People's Democratic Republic

Abstract

Objectives: To design tailor-made interventions (TMIs) for patients with diabetes at Setthathirat hospital in Lao People's Democratic Republic (Laos PDR) Methods: This study was undertaken at Diabetes clinic, Setthathirat Hospital in Lao PDR, using mixed research methods. There were 2 main phases. Phase 1 was the cross-sectional descriptive study in patients with at least 45 years old, having type 2 diabetes with or without hypertension, having hemoglobin A1c (HbA1c) ≥7% and fasting blood sugar > 130mg/dL. Patients’ knowledge about diabetes and its management was measured using the 24-item Diabetes Knowledge Questionnaires (DKQ). Brief Medication Questionnaires (BMQ) were used to measure patient’s compliance. Drug-related problems (DRPs) were identified and classification using the criteria of the Pharmaceutical Care Network Europe working group (PCNE Version 9.1, 2020). Phase 2 involved focus group interviews with all health care professionals working at the Diabetes Clinic in Setthathirach Hospital based on the information from phase I. The interviews were conducted to brainstorm and design TMIs suitable for the practice. Results:  One hundred and ten participants were recruited. The majority was female (59.1%), with the mean age of 56.00±9.20 years. The average fasting blood sugar was 185±65.31 mg/dL and HbA1c was 9.26±1.94%. The majority of subjects (86 or 78.18%) had the score on the DKQ ranging from 9 to 18 from the full score of 24. Forty percent of the subjects were considered non-compliant as measured by the BMQ. The most common DRP was “P1.1 no effect of drug treatment” (85.5% of the subjects). Phase II study identified three major themes related to establishing TMIs including views of services, views of organizational barriers, and roles of health care professionals for providing TMIs. Recommendations for utilizing assessment and educational tools as well as pharmacist’s roles in providing TMIs with doctors and nurses for patients with DRPs and poor outcomes were proposed. Conclusion: The health care team agreed on the importance of providing TMIs for diabetic patients with poor compliance and health outcomes. This approach may help not only to improve standards of patient care but also patients’ health outcomes.