IDF21-0566 Adherence to Foot and Eye exams Among People Living with Diabetes in Nigeria

Abstract

Background: Adverse outcomes of diabetes such as diabetic foot gangrene and diabetic retinopathy are often as a result of poorly controlled glycemia and late detection of early signs of complications. But even where people are informed about these complications of diabetes, there is sparse data in Nigeria on whether patients with diabetes undergo routine foot and eye exams. mDoc is a digital health social enterprise which provides virtual self-care support to people living with regular and chronic health conditions including diabetes through our CompleteHealth™ platform. In our service provision, we see many members with diabetes and noticed that only a few of them reported having eye or foot exams. This presentation describes how we surveyed members to get a clear picture of their adherence to foot and eye exams in Nigeria. Aim: To examine adherence to foot and eye exams among people living with diabetes in Nigeria, using a digital self-care platform. Method: This was a survey conducted on members with diabetes registered on the mDoc CompleteHealth™ platform between September 2020 and August 2021. After onboarding, members were provided with self-care support through the mDoc’s virtual omni-channel support system: weekly messages were sent via CompleteHealth™ to members and the coach-led multidisciplinary care teams (including a nutritionist and fitness coach). They were provided with lifestyle modifications on diet and exercise as well as self-care education on diabetes management and the importance of foot and eye care. Also, they received advice on regular blood glucose levels checks and medication adherence. Members could also enter and track their health metrics via the CompleteHealth™ platform. The survey was administered by the health coach who called members to offer self-care guidance and advice on diabetes management. The members were asked if they had undergone a foot and/or an eye exam in the 12 months preceding the survey. Afterwards, data was collected via CompleteHealth™ for the analysis. Results: 103 members were contacted as part of the survey. Of these, 77 members responded at the time of calling. All 77 members responded to the first question regarding adherence to foot care. Of these, only 8 (10.5%) had undergone a foot exam in the preceding year. 71 members responded to the second question regarding adherence to eye care, and of these 16 (22.5%) answered “yes” indicating they had done one. Discussion: Our study showed that despite educating people with diabetes on the importance of foot and eye care and providing them with self-care support, there was low adherence to foot and eye exams. Although there was a general decrease in the average fasting blood glucose among members with diabetes of the platform (there was a reduction of 19 mg/dL among members over the same period), it is alarming to see such low adherence figures. While education on the control of diabetes is an important tool in reducing the incidence of retinopathy and foot complications, there is also a need to increase access to foot and eye care which is low across Africa.