Evaluation of the NCD@HOME Project to Manage Treatment and Care of Diabetes and Hypertensive Disorder Patients in Wattana Nakhon District, Sa Kaeo Province

Abstract

This study aims to evaluate the NCD@Home Project for diabetes and hypertensive disorder patients in Wattana Nakhon of Sa Kaeo province by applying the Logic Model as the evaluation framework. There were 26 key informants interviewed in this study, including physicians, pharmacists, nurses and IT staff, using a project data collection form, an in-depth interview question guideline, a focus group discussion question guideline and an interview question guideline and then followed by content analysis for qualitative data and numbers and percentage for quantitative data.

It was found that after the project exposure, the diabetic patients possess the HbA1c level at the controllable level at 83.9, however, lower than before the exposure (96.4%). On the contrary, hypertension patients could maintain their blood pressure significantly indifferent (98.3% and 100.0% respectively). There were no repeated visits among those reported to have ever been hospitalized as in-patients within two years before participating in the intervention. The overcrowding situation for both types of patients has been slightly minimized. Missing doctor’s appointments decreased at the beginning but later increased. The training curriculum was proved to be appropriate but lack of refreshers’ courses to ensure the continuity. The selection criteria of participants into the intervention were too strict, resulting in limited number of eligible participants, hence a small number of participants. The use of technology in home visits, health monitoring and evaluation has been minimized. The burdens during the Coronavirus 2019 epidemic have affected the home visit and home drug delivery protocol. The budget for capacity building and equipment support for home visits is insufficient. There is appropriate information technology but still redundancy of data entry in addition to what must be done. Therefore, responsible staff members should be clearly identified to monitor the project together with the health network, develop the data system so that they can be linked with the existing database and programs in order to reduce the burdens as well as supporting the village health volunteers to ensure the continuity of their actions.