x Abu Dhabi, UAEThursday 18 January 2018

Diabetes counselling scheme to extend to other conditions

Daman's disease management programme to support Emirati patients with diabetes will soon be extended to cover asthma patients.

ABU DHABI // A successful scheme to provide free counselling to Emirati diabetics will soon be extended to cover other chronic conditions.

Daman, the Abu Dhabi government's health insurance company, launched a disease management programme two years ago that was free for Emiratis with a Thiqa insurance card. Dedicated health coaches, most of them Emirati, were hired and trained to work with patients and offer them personal support and medical counselling to deal with their diabetes and consequent obesity - chronic conditions that are best managed through lifestyle intervention.

The payoff: patients in the programme have shown significant improvements in their blood sugar levels.

Because the programme has been so beneficial, next month Daman is to launch a disease management programme for patients with asthma. Maternity management is also on the horizon, to help pregnant women and new mothers seeking information on everything from breast feeding to postpartum depression.

Under the programme, the coaches are faceless to the patients; nothing more than a name and a voice on the telephone. But once a month, without fail, each coach makes a scheduled call to ensure his diabetic patients are on the right track and in control of the disease, thereby ensuring that diabetics are not left to their own devices.

Dr Alfons Grabosch, manager of health support at Daman and the mastermind behind the disease management programme, said the project is essentially a form of prevention.

"Doctors don't have enough time to provide this kind of follow-up for every patient or to explain again and again what it means to have control; we fill this gap," he said.

While the patients already have a chronic disease, Dr Grabosch said the project, by teaching them how to manage it, can prevent often-fatal complications.

"The programme helps patients live with their condition and achieve a better quality of life," he said. "We don't treat them; the doctors do that. We are here to help them understand what it means to be diabetic and obese. We make them aware of the consequences of their disease, what are the possible complications, how to avoid them, how to self-manage."

Emiratis with a medical background, from nutritionists to clinical pharmacists, were trained to influence patients to change their lifestyle.

"There are cultural issues that go into reaching out to an Emirati, so we wanted like-minded individuals to speak to our patients," Dr Grabosch said.

The coaches develop a rapport with their patients. In their monthly phone call, they ask about blood sugar levels, weight, diet, exercise, social problems and cholesterol levels. They set targets with their patients. They begin asking after the patient's family members.

In fact, the patients feel more comfortable asking their coaches pressing questions, rather than waiting to see their doctor, said one of the coaches, Dr Shada al Ghazali.

Dr al Ghazali, an Emirati dentist by training, became one of the medical education coordinators in the programme 14 months ago. She monitors 150 patients a month.

"The patients love being able to contact us anytime, and they don't hesitate to do that," she said. "They ask what to do if they have a sudden low blood sugar, or where to find an ophthalmologist or how much exercise to do per week. We refer them to a doctor when needed, of course, but they know we have the time to talk to them."

A phone call can last anywhere from 15 minutes to two hours, she said.

"One of the patients I monitor is a 47-year-old Emirati who quit smoking with my help. He sees his doctor regularly now, when before he used to avoid his appointment, and he is in control of his blood sugar," Dr al Ghazali said.

Another patient, a 21-year-old university student, did not accept her diabetes diagnosis because she thought Type 2 could not strike someone so young.

Dr al Ghazali was able to help the student begin to lose weight, and the students has come to rely on her encouragement.

"It is very inspiring to know that I am making a difference," Dr al Ghazali said.

Dr Grabosch said the programme hoped to add more participants. There are currently 2,400 patients involved, whereas 25,000 Emiratis have been identified by the Daman database as having Type 2 diabetes in the emirate.

"There is a lack of awareness that we need to overcome," he said.

The programme includes free information sessions for patients that cover everything from foot care to how to cook with less fat.

"Patients think they are fine and don't need us because they feel healthy, not sick, and that's the danger: diabetes is a silent killer," Dr Grabosch said.

Salem al Matroushi, 59, one of the patients enrolled in the programme, had thought his diabetes was no big deal, because he felt healthy.

"It is really a matter of education, and I didn't know what I was lacking in knowledge," he said. "Every patient will have a different level of knowledge of their disease, and that is where the coaches step in and fill in the blanks."

Mr al Matroushi said that the motivation he gets from his coach every month is invaluable.

"I am too afraid to gain any weight or fall back on exercising, because when I get that phone call, I don't want to have to answer to any bad news," he said.