Effectiveness And Appropriateness Assessment Of Blood Glucose Monitoring Technology And Its Community Application In Songjiang District Shanghai

Objective1. To investigate the current status of application of blood glucose monitoring technology in a community in Songjiang District, Shanghai, and to evaluate the effectiveness and appropriateness of the technology.2. To analyse the related factors which affect the application of blood glucose monitoring technology and to provide ecommendations for promoting the application of the technology.Subjects and MethodsA cross-sectionalstudy was employed and 152 diabetes patients who were under the management of local community health center in Songjiang District were sampled through a systematic sampling method. The subjects underwent a questionnaire survey and the content of which included accessibility, effectiveness, safety of the blood glucose monitoring technology, ratings of patients'satisfaction and compliance of the technology as well as the outpatient and emergency department and inpatient costs. An EpiData 3.1 software was used to establish the database and Statistical Analysis System version 9.3 was employed to data analysis. Data description was conducted by descriptive analysis method(mean, median, percentage, et al.). Data were analysed through rank-sum test and Chi-square test.Results1) Adherence:116 patients(76.3%) of all the subjects monitored fasting blood glucose(FBG), among whom 54 (35.5%) and 51 (33.6%) patients monitored FBG once a week and once a season respectively.30 subjects monitored postprandial blood glucose(PBG),13 (8.6%) monitored PBG once a season and 6 (3.9%)monitored once a year. Only 15 (9.9%) monitored HbA1c. Chi-square test indicated the more the glucose monitoring technology helped the patients to be aware of diabetes, to accompany with doctors to control their blood glucose and the more the patients were satisfied with their monitoring results, the more the patientsmonitored FBG.2) Accessibility:94.1% of the subjects monitored blood glucose in community health centers, 91.4% were able to walk to the community health centre within 30 minutes and 88.8% of the patients received blood glucose monitoring service within 30 minutes. And the average cost of blood glucose monitoring for a patient was 6.07 RMB/month.3) Safety:More than 99% of the patients reported neitherdiscomfort during blood glucose monitoring nor the leakage of their monitoring information.4) Effectiveness:The study manifested that 74.3% of the subjects deemed blood glucose monitoring helped them to learn more about diabetes,75% held that the technology helped them to accompany with doctors to control their blood glucose levels and 73% thought that the technology did assist them in identifying and coping with abnormal blood glucose.5) Satisfaction:90.2% of the subjects were satisfied with the blood glucose monitoring discipline and their execution,78.3% were satisfied with the effect of glucose monitoring.6) There was no correlation between the direct cost of both outpatient and emergency service and whether the frequency of FBG monitoring reached the standard.Conclusions1) From the perspective of patients with diabetes, it's effective and appropriate to monitor fasting blood glucose at least 4 times per year in Songjiang District, Shanghai.2) The study didn't indicate whether the frequency of FBG monitoring reached the standard would give rise to different direct cost of both outpatient and emergency service.The reason needs to be further investigated.