Authors (including presenting author) :
Chung HY (1), Choi YK (1), Leung SY (1), Leung KW (1)
Affiliation :
(1) Department of Family Medicine, NTEC
Introduction :
Some General Outpatient Clinics (GOPCs) were switched to medication refill clinic (MRC) due to manpower shortage during the 5th wave of COVID-19 outbreak. Under the MRC care model, patients obtained chronic medication without doctor consultation unless necessary. It is important to review the performance of MRC to determine whether it could be confidently implemented in future pandemic or even as routine care.
Objectives :
To assess the feasibility and safety of MRC among diabetic patients in GOPC.
Methodology :
A retrospective cohort study comparing Lek Yuen (LY) GOPC (MRC) with Shek Wu Hui (SWH) GOPC (usual service) from 15th March 2022 to 12 May 2022. All patients with Type II diabetes mellitus (DM) who had appointments in LY or SWH. High-risk patients under special DM clinic were excluded. Primary outcomes measured the feasibility by comparing the attendance rate between two clinics and measuring the proportion of face-to-face consultation in LY. Secondary outcomes measured the safety by comparing the change in HbA1c and LDL, emergency department attendance rate, hospitalization rate and death rate between two clinics.
Result & Outcome :
6999 DM patients were included. Both clinics had more than 99% attendance rate. 17.65% attendances in LY were face-to-face consultation. Improvement in HbA1c (LY: -0.248, 95% CI -0.220 to -0.277, p <0.01; SWH: -0.260, 95% CI -0.211 to -0.309, p<0.01) and LDL (LY: -0.155, 95% CI -0.131 to -0.180, p<0.01; SWH: -0.105, 95% CI -0.064 to -0.147, p<0.01) were observed in both clinics. LY had significantly better improvement in LDL (β = -0.057, 95% CI -0.104 to -0.010, p=0.018). LY had significantly lower rate of emergency department attendance (OR 0.657, p<0.001), hospitalization (OR 0.712, p<0.001) and death (OR 0.485, p<0.01) compared with SWH.
