Treatment outcomes in a cohort of Palestine refugees with diabetes mellitus followed through use of E‐Health over 3 years in Jordan

Abstract

Abstractobjective The aim of this study was to use E-Health to report on 12-month, 24-month and 36-month outcomes and late-stage complications of a cohort of Palestine refugees with diabetes mellitus (DM) registered in the second quarter of 2010 in a primary healthcare clinic in Amman, Jordan.method Retrospective cohort study with treatment outcomes censored at 12-month time points using E-Health in UNRWA's Nuzha Primary Health Care Clinic.results Of 119 newly registered DM patients, 61% were female, 90% were aged ≥40 years, 92% had type 2 DM with 73% of those having hypertension and one-third of patients were newly diagnosed. In the first 3 years of follow-up, the proportion of clinic attendees decreased from 72% to 64% and then to 61%; the proportion lost to-follow-up increased from 9% to 19% and then to 29%. At the three time points of follow-up, 71-78% had blood glucose ≤180 mg/dl; 63-74% had cholesterol <200 mg/dl; and about 90% had blood pressure <140/90 mmHg. Obesity remained constant at 50%. The proportion of patients with late-stage complications increased from 1% at baseline to 7% at 1 year, 14% at 2 years and 15% at 3 years.conclusion Nuzha PHC Clinic was able to monitor a cohort of DM patients for 3 years using E-Health and the principles of cohort analysis. This further endorses the use of cohort analysis for managing patients with DM and other non-communicable diseases.

Managing and monitoring chronic non-communicable diseases in a primary health care clinic, Lilongwe, Malawi

“…Over time, the EMR will also allow a survival analysis of each particular cohort to assess the quality of disease control, the development of co-morbidities and the programmatic outcomes, as has been undertaken in Jordan. 20 Such information, updated and produced every quarter, will allow the clinic not only to review and assess the growing case load but also to rationally plan for human resources, drugs and consumables that are needed at the facility level.…”

UNRWA’s innovative e-Health for 5 million Palestine refugees in the Near East

“…[7][8][9][10][11][12][13][14][15] The use of data extracted from UNRWA e-Health system was important to support the secondary use of the system in cohort analysis, as documented in several studies published by UNRWA HP. [25][26][27][28] conclusIons And WAy forWArd The e-Health system developed and deployed by UNRWA at its PHC facilities has proven to be an essential tool for a cost-effective, patient-centred, better healthcare quality, in addition to equitable, fair and sustainable healthcare services via such an ICT health application.…”

Primary healthcare reform in the United Nations Relief and Works Agency for Palestine Refugees in the Near East

“…Khader and colleagues highlighted the role played by e-Health in supporting drug-procurement policies, monitoring NCD risk factors, and evaluating the quality of care over time by identifying the occurrence of late complications of NCDs (25)(26)(27)(28)(29). Additionally, the Agency's internal assessments reported widespread satisfaction with the new FHT approach among both providers and patients.…”

“…When any family member attends a health centre, the record highlights non-attendance by other members. UNRWA evaluations show that e-Health provides accurate information about numbers of patients, services provided and outcomes of care (25)(26)(27)(28)(29).…”

“…The drug-procurement policies were also redesigned (31). Health information systems units were established at all levels to facilitate the collection and utilization of electronic data to inform policy making (25)(26)(27)(28)(29). Furthermore, new staff payment mechanisms are regularly updated in order to incentivize the health workforce.…”