Endocrine Abstracts

Introduction: All patients 12-years-old and above with diabetes mellitus should receive the 9 care processes recommended by National Institute for Health and Care Excellence (NICE) annually. This is because it can reduce risks of complications or detect them earlier. The 9 parameters include HbA1c, blood pressure, cholesterol, retinal screening, feet examination, urine albumin creatinine ratio, creatinine, weight and smoking status. Since the Covid-19 pandemic, many consultations were moved to telephone/video calls. This begged the question of whether patients were still receiving all the care processes despite not having face-to-face consultations. Hence, an audit was done in a district general hospital to determine if all appropriate patients with diabetes were receiving the care processes.

Methods: Data was collected retrospectively from December 2022 till January 2023 over a 6-weeks period involving 3 consultants’ clinics using letters from the trust’s electronic health records. Sample size was 108 – 60 patients had type 1 diabetes, 43 type 2, and 5 had diabetes due to miscellaneous causes.

Results: Amongst the 108 patients, 7 patients only had telephone consultations in the previous 18-24 months; the rest had mixtures. Only 14 out of 108 patients had all parameters checked; 44 had eight out of nine checked (42 did not have smoking history documented, 2 did not have retinal screening mentioned).

Discussions: Majority of the patients did not receive all nine care processes. Virtual consultations could have contributed as it could be harder for clinicians to address some of the parameters during such consultations, for example, feet examination. There is also a possibility that doctors in hospitals are assuming Primary Care is addressing them and therefore prioritise less on these parameters during the virtual consultations. Hence, there is also a need to create awareness of addressing all these care processes annually, irrespective of virtual or face-to-face consultations.