8 research outputs found
Patient Views on Quality of Life and Hospital Care: Results From a Qualitative Study Among Vietnamese Patients With Diabetes
Objectives: This study aimed to fill the gap between Vietnamese diabetic patients' needs and care through a qualitative study asking about their experiences with diabetes and quality of care.
Methods: Interviews with five diabetic patients were conducted at a tertiary general hospital located in southern Vietnam. The transcribed data were first subjected to quantitative text analysis using KH Coder to identify major categories of frequently used words, followed by a qualitative analysis of selected cases using the Steps for Coding and Theorization (SCAT) method.
Results: The major categories of frequently used words were chronic health conditions, services, facilities, insurance, patient-doctor communication, and medication. SCAT analysis of three selected cases identified six themes: âDisregarding the disease at the early stage,â âFear of complications,â âSatisfaction with hospital services and medical staff,â âInsurance-related problems,â âLong waiting times,â and âCommunication barriers between patients and doctors.â Patients were satisfied with improved hospital facilities and services; however, the overloading of one hospital led to long waiting times and communication difficulties with doctors. Difficulties with health insurance were also observed, and patients were rather passive in disease management and needed to be empowered through improved communication with doctors and other care providers.
Conclusion: These findings from our trial of introducing a qualitative study into service evaluation suggest that listening to patients can help health providers learn their perspectives and be more responsive to their needs
Internet analytics of an innovative digital educational resource of type 1 diabetes HelloType1 in local languages for people living with diabetes families and healthcare professionals in Southeast Asia.
BackgroundThere is minimal data of health outcomes for Type 1 Diabetes (T1D) in Southeast Asia (SEA) where government funding of insulin and blood glucose monitoring either do not exist or is limited. The full impact of Covid-19 pandemic on the national economies of SEA remain unknown. In the midst of the pandemic, in 2021, HelloType1 was developed by Action4Diabetes (A4D), a non-government organisation charity in collaboration with Southeast Asia local healthcare professionals as an innovative digital educational resource platform of T1D in local languages. HelloType1 was launched in Cambodia, Vietnam, Thailand and Malaysia in 2021 to 2022 with Memorandums of Understandings (MOUs) signed between A4D and each country. Internet data analytics were undertaken between the 1st of January 2022 to 31st of December 2022.AimsThe aims of this study were to explore the usability and internet data analytics of the HelloType1 online educational platform within each country.MethodsThe data analytics were extracted Google analytics that tracks data from the website hellotype1.com and Facebook analytics associated with the website.ResultsThere was a 147% increase in the number of HelloType1 users between the first 6 months versus the latter 6 months in 2022 and a 15% increase in the number of pages visited were noted. The majority of traffic source were coming from organic searches with a significant increase of 80% growth in 2022.ConclusionsThe results of the analytics provide important insights on how an innovative diabetes digital educational resource in local languages may be optimally delivered in low-middle income countries with limited resources
The High Re-Ulceration Rate in Lower Extremity Amputation Intervention in Type 2 Diabetic Vietnamese Patients After 24-Month Follow-Up at Cho Ray Hospital, Vietnam
Diabetic foot ulcers (DFU) are a prevalent and severe disease with vascular and/or neurological complications, and if not diagnosed and treated promptly, it may rapidly deteriorate. Despite amputation or nonamputation treatment, there is still a high rate of re-ulceration. Previous studies have shown that the recurrence rate varies from 43% to 59% after 2âyears. Currently, there is still a high rate of lower extremity amputation intervention, particularly above-the-ankle amputation, at Cho Ray Hospital in Vietnam, reaching 50%. The effectiveness of this intervention in the long term based on re-ulceration has not been evaluated in Vietnamese diabetic patients (DPs). This study aims to describe the long-term outcomes of amputation intervention in Type 2 DPs after 24âmonths and identify factors related to DFU recurrence in order to improve DFU management in low-middle-income countries like Vietnam. From January to June 2022, archived clinical and direct visit or phone follow-up data were collected and analyzed from diabetic foot ulcer patients with low extremity amputation who were treated at Cho Ray hospital from 2018 to 2020. The high re-ulceration rate in the 24th month was 29.8% (17/57), and the factor related to this outcome was âlate diagnosis and careâ (32.4âdays vs 26.9âdays with P â=â.03). Other potential factors (higher rates but no significant statistical difference with P â>â.05) included failure of HbA1c control greater than 9% (82.5% vs 67.5%), the severity of foot ulcers with TEXAS 3B (82% vs 60%), the number of years having diabetes (8.7âyears vs 6.7âyears), loss of monofilament sensation (82.5% vs 70.6%), and a history of diabetic foot ulcer (17.6% vs 10%). The re-ulceration after 24âmonths might depend on various clinical factors. Therefore, early diagnosis and care for diabetic foot ulcers could help reduce amputation rates and the risk of re-ulceration
Epidemiology research training in Vietnam: evaluation at the five year mark
Recently, the importance of research capacity development has been rediscovered as a vital approach to help strengthen health systems for improved global health. The University of Medicine and Pharmacy, Ho Chi Minh City (UMP) in Vietnam in collaboration with the Department of Public Health at the Fukushima Medical University School of Medicine (PHFMU) developed an epidemiology training course for mid-career Vietnamese physicians. We trained a total of 128 participants over four courses since 2004. In order to balance basic and advanced course content for first-time and returning participants, we encouraged active participation of past graduates in teaching Course IV in 2009. Not only did this provide further training opportunities for advanced learners, it also increased project ownership by Vietnamese participants. Although more rigorous evaluation is needed, we believe that this summary of our past activities presents a useful example for others undertaking similar initiatives. To further upgrade the project in Vietnam, institutional support is required to nurture a strong scientific emphasis as well as self-sustainability in research capacity development
Screening, diagnosis and management of diabetic sensorimotor polyneuropathy in clinical practice
Diabetic sensorimotor polyneuropathy (DSPN) affects around one third of people with diabetes and accounts for considerable morbidity, increased risk of mortality, reduced quality of life, and increased health care costs resulting particularly from neuropathic pain and foot ulcers. Painful DSPN is encountered in 13-26% of diabetes patients, while up to 50% of patients with DSPN may be asymptomatic. Unfortunately, DSPN still remains inadequately diagnosed and treated. Herein we provide international expert consensus recommendations and algorithms for screening, diagnosis, and treatment of DSPN in clinical practice derived from a Delphi process. Typical neuropathic symptoms include pain, paresthesias, and numbness particularly in the feet and calves. Clinical diagnosis of DSPN is based on neuropathic symptoms and signs (deficits). Management of DSPN includes three cornerstones: 1.) lifestyle modification, optimal diabetes treatment aimed at near-normoglycemia, and multifactorial cardiovascular risk intervention, 2.) pathogenetically oriented pharmacotherapy (e.g. α-lipoic acid and benfotiamine), and 3.) symptomatic treatment of neuropathic pain including analgesic pharmacotherapy (antidepressants, anticonvulsants, opioids, capsaicin 8% patch and combinations, if required) and non-pharmacological options. Considering the individual risk profile, pain management should not only aim at pain relief, but also allow for improvement in quality of sleep, functionality, and general quality of life
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Abstract Aims To investigate the effectiveness, safety, optimal starting dose, optimal maintenance dose range, and target fasting plasma glucose of five basal insulins in insulinânaĂŻve patients with type 2 diabetes mellitus. Methods MEDLINE, EMBASE, Web of Science, and the Cochrane Library were searched from January 2000 to February 2022. The Preferred Reporting Items for Systematic Reviews and MetaâAnalyses (PRISMA) guidelines were followed and the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach was adopted. The registration ID is CRD42022319078 in PROSPERO. Results Among 11â163 citations retrieved, 35 publications met the planned criteria. From metaâanalyses and network metaâanalyses, we found that when injecting basal insulin regimens at bedtime, the optimal choice in order of most to least effective might be glargine Uâ300 or degludec Uâ100, glargine Uâ100 or detemir, followed by neutral protamine hagedorn (NPH). Injecting glargine Uâ100 in the morning may be more effective (ie, more patients archiving glycated hemoglobinâ<â7.0%) and lead to fewer hypoglycemic events than injecting it at bedtime. The optimal starting dose for the initiation of any basal insulins can be 0.10â0.20âU/kg/day. There is no eligible evidence to investigate the optimal maintenance dose for basal insulins. Conclusions The five basal insulins are effective for the target population. Glargine Uâ300, degludec Uâ100, glargine Uâ100, and detemir lead to fewer hypoglycemic events than NPH without compromising glycemic control
Combined associations of family history and self-management with age at diagnosis and cardiometabolic risk in 86,931 patients with type 2 diabetes: Joint Asia Diabetes Evaluation (JADE) Register from 11 countries
Abstract Background Family history (FamH) of type 2 diabetes might indicate shared genotypes, environments, and/or behaviors. We hypothesize that FamH interacts with unhealthy behaviors to increase the risk of early onset of diabetes and poor cardiometabolic control. Methods In a cross-sectional analysis of the prospective Joint Asia Diabetes Evaluation Register including patients from 427 clinics in 11 Asian countries/regions in 2007â2021, we defined positive FamH as affected parents/siblings and self-management as (1) healthy lifestyles (balanced diet, non-use of alcohol and tobacco, regular physical activity) and (2) regular self-monitoring of blood glucose (SMBG). Results Among 86,931 patients with type 2 diabetes (mean±SD age: 56.6±11.6 years; age at diagnosis of diabetes: 49.8±10.5 years), the prevalence of FamH ranged from 39.1% to 85.3% in different areas with FamH affecting mother being most common (32.5%). The FamH group (n=51,705; 59.5%) was diagnosed 4.6 years earlier than the non-FamH group [mean (95% CI): 47.9 (47.8â48.0) vs. 52.5 (52.4â52.6), logrank p<0.001]. In the FamH group, patients with both parents affected had the earliest age at diagnosis [44.6 (44.5â44.8)], followed by affected single parent [47.7 (47.6â47.8)] and affected siblings only [51.5 (51.3â51.7), logrank p<0.001]. The FamH plus â„2 healthy lifestyle group had similar age at diagnosis [48.2 (48.1â48.3)] as the non-FamH plus <2 healthy lifestyle group [50.1 (49.8â50.5)]. The FamH group with affected parents had higher odds of hyperglycemia, hypertension, and dyslipidemia than the FamH group with affected siblings, with the lowest odds in the non-FamH group. Self-management (healthy lifestyles plus SMBG) was associated with higher odds of attaining HbA1c<7%, blood pressure<130/80mmHg, and LDL-C<2.6 mmol/L especially in the FamH group (FamHĂself-management, pinteraction=0.050â0.001). Conclusions In Asia, FamH was common and associated with young age of diagnosis which might be delayed by healthy lifestyle while self management  was associated with better control of cardiometabolic risk factors especially in those with FamH