The Effectiveness of Conducting Home Visits by Medical Students among Malaysians with Type 2 Diabetes: A Retrospective Analysis

Abstract

Background.Medical students at the International Medical University (IMU), Seremban, Malaysia were required to assess patients at home over a period of two years as a part of their curriculum. The students conducted six visits to educate their patients and help them utilize available resources to manage their disease. This study aims to examine whether diabetic patients visited improve their control of their disease, specifically in terms of their HbA1c measurement. Methodology.We used a retrospective, matched case-control study design to prevent biased levels of effort by students conducting the home visits over two years. Information was obtained through reports written by IMU students. Convenient sampling was used to select outpatients undergoing treatment ‘as usual’ from a health clinic and were subsequently matched as controls. Results.There was a significant decrease in the mean HbA1c among 57 patients with diabetes who were CFCS subjects [from 8.4% (68 mmol/mol) to 7.3% (57 mmol/mol) p<0.001], while the mean HbA1c levels among 107 matched control subjects rose significantly from 7.9% (63 mmol/mol) to 8.3% (67 mmol/mol) (p=0.019) over a similar period. The two groups were controlled for most biological and socioeconomic variables except for comorbidities, diabetic complications and medication dose changes between groups. Conclusion.Behavioural intervention in the form of home visits conducted by medical students is an effective tool with a dual purpose, first as a student educational initiative, and second as a strategy to improve outcomes for patients with diabetes

Keywords

• home visits
• medical students
• type 2 diabetes
• glycated hemoglobin
• Malaysia