The findings of this study provide further evidence for Hong
Kong and other Asian countries to drive the paradigm shift of
the healthcare delivery model from a very ‘doctor centred’
approach towards being more ‘patient centred’, with more
emphasis on medical education and community care rather than
mainly hospital based management. The findings also provide
outcome data reflecting the effectiveness of the chronic care
model to those healthcare professionals who spend most of their
training time in the acute medical model of care, with little
understanding and appreciation of how this type of partnership
can result in better care for patients. The real world practice
might not have given strong consideration to interventions that
would improve patient empowerment and lifestyle modifications,
with greater support in patient self management resulting
in a suboptimal proportion of diabetic patients reaching their
desirable targets. Diabetic programmes in Cambodia consisting
of outpatient clinics with GPs, nurses, drug educators, and
adherence counsellors showed significant clinical improvements
in glycaemic control, but only a relatively low proportion of
patients reached their treatment targets.37 A study on AfricanAmerican
adults has shown the importance of incorporating the
empowerment principles in supporting DM patient self
management in ‘real world’ settings.38 The DESMOND study in
UK has demonstrated changes in perceived personal responsibilities,
with lower scores of depression and lifestyle improvement
among the intervention group subjects, although there
was no significant difference in HbA1c after adjustment.39 One
must take into consideration that the majority of diabetes
patients in the UK have had their biomedical variables recorded
and translated into good clinical outcomes, but not many
countries in this part of the world would achieve this target.
Therefore, an active diabetes self management programme is
very much needed.
The findings of this study provide further evidence for Hong
Kong and other Asian countries to drive the paradigm shift of
the healthcare delivery model from a very ‘doctor centred’
approach towards being more ‘patient centred’, with more
emphasis on medical education and community care rather than
mainly hospital based management. The findings also provide
outcome data reflecting the effectiveness of the chronic care
model to those healthcare professionals who spend most of their
training time in the acute medical model of care, with little
understanding and appreciation of how this type of partnership
can result in better care for patients. The real world practice
might not have given strong consideration to interventions that
would improve patient empowerment and lifestyle modifications,
with greater support in patient self management resulting
in a suboptimal proportion of diabetic patients reaching their
desirable targets. Diabetic programmes in Cambodia consisting
of outpatient clinics with GPs, nurses, drug educators, and
adherence counsellors showed significant clinical improvements
in glycaemic control, but only a relatively low proportion of
patients reached their treatment targets.37 A study on AfricanAmerican
adults has shown the importance of incorporating the
empowerment principles in supporting DM patient self
management in ‘real world’ settings.38 The DESMOND study in
UK has demonstrated changes in perceived personal responsibilities,
with lower scores of depression and lifestyle improvement
among the intervention group subjects, although there
was no significant difference in HbA1c after adjustment.39 One
must take into consideration that the majority of diabetes
patients in the UK have had their biomedical variables recorded
and translated into good clinical outcomes, but not many
countries in this part of the world would achieve this target.
Therefore, an active diabetes self management programme is
very much needed.
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