Introduction: Long waiting time is a common issue complained by diabetic patients that came for an
early morning appointment in a health clinic. Therefore, an audit was conducted among diabetic patients in
a primary care clinic with the aim to assess the patients’ waiting time and to formulate strategies for
improvement. Methods: This audit was conducted for four weeks using a universal sampling method in
November 2017. All diabetic patients who attended the clinic during this period were included except those
who required longer period such as critically ill patients or those who came for repeat medication or
procedures. The arrival and departure time for each station was captured using the modified waiting time
slip, which is manually filled at every station. The waiting and consultation time for registration, screening,
laboratory investigation, diabetic educator, doctor and pharmacy were recorded. The data were entered into
the statistical software SPSS version 17 for analysis. Results: Results showed that all patients were registered
within 11.0 minutes (SD=2.52min). Average total waiting time to see a diabetic educator and a doctor was
20.9 minutes (SD=15.53min) and 33.23 minutes (SD=27.85min), respectively. Average waiting time for other
stations was less than 10 minutes. Average total time spend in the clinic for a diabetic patient was 107.58
minutes, which is comparable to a non-diabetic patient. The identified problems were due to the poor
tracing and filing system. Conclusion: Improvement strategies recommended include enforcing early file
tracing prior to appointment and providing a checklist for consultation by doctors and diabetic educators.
Introduction: Clinical resolution of periodontitis (CRP) of type-2 diabetic patients with chronic periodontitis (T2DM-PD) after receiving non-surgical periodontal treatment (NSPT) has been reported in the previous studies. This study aimed to evaluate CRP of T2DM-PD under medicaldental coordinated care (M-DCC). Materials and Methods: A 6-months follow-up quasi-experimental study was conducted among 20 subjects who received M-DCC in 2016. M-DCC included standard diabetic care provided by medical professional from 3 health clinics and NSPT provided by periodontal specialists from two periodontal specialist clinics. Target glycemic control achievement (TGCA) HbA1c 6.5% was assessed at baseline and 6 months after NSPT. Clinical resolution of PD was measured in terms of BPE, BOP %, CAL(mm), PPD(mm), PPD 4mm, PPD =4 mm and PPD 6mm at baseline, 3 and 6 months. Paired simple t test and ANOVA F test were applied to infer clinical resolution of periodontitis and its relation to TGCA.
Results: Mean (SD) of average BPE at baseline, 3- and 6-months were 3.52(0.34), 3.12(0.33) and 3(0.45) with (p<0.05); average PPD(mm) were 3.33(0.5), 3.23(0.75) and 2.73(0.57) with (p<0.05); PPD(%) 4mm were 71.03(12.33), 82.77(9.9) and 85.85 (8.9) with (p<0.05); PPD(%) =4 mm were 27.94(11.9), 16.97(10.01) and 13.71(9.1) with (p<0.05); PPD(%) 6mm were 8.04(4.32), 2.66(2.3) and 1.87(2.32) with (p<0.05). Significant resolution of BPE, CAL(mm) and PPD(mm) was noticed among two subjects who has changed from uncontrolled TGCA to controlled TGCA.
Conclusion(s): CRP and TGCA results have verified the effectiveness of M-DCC. A further clinical control trial with adequate sample size needs to confirm the results of the present study.
KEYWORDS: clinical resolution, chronic periodontitis, periodontal therapy, target HbA1C%, Type-2 Diabetic Patients with chronic periodontitis