Evaluating the impact of an international short-term medical mission through diabetic glycemic control

• Published in: Journal of public health (Oxford, England) Vol. 41; no. 4; pp. 815 - 820
• Main Authors: Mach, John C, Barone, Hope, Boni, Christopher, Jimenez, Humberto, Tinglin, Michael
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 20-12-2019
• Subjects: diabetes; public health; health impact assessment
• ISSN: 1741-3842; 1741-3850
• DOI: 10.1093/pubmed/fdy182

Abstract
Background
This prospective observational study evaluated the impact of a primary care-based, international, short-term medical mission’s (STMM) impact on diabetes disease burden as represented through reductions in hemoglobin A1C (HbA1c).
Methods
From November 2016 to May 2017, we tracked the HbA1c’s of diabetic individuals in Dajabon, Dominican Republic through care provided by Waves of Health (WOH). Participants were provided counseling, glucose monitoring equipment, a 6-month supply of anti-diabetic medications, and received a ‘check-in’ phone call at 3 months. HbA1c’s were re-measured at 6-month follow up. We hypothesized WOH diabetic care would have a modest impact of reducing mean HbA1c by 0.5%.
Results
In total, 75% (n = 76) of 101 participants presented for follow-up care. Mean and median HbA1c decreased from 8.71 (SD 2.0) and 8.5% to 8.36 (SD 2.1) and 7.7%, respectively (P = 0.07). The percentage of individuals with HbA1c ≤7.5 increased by 10.4% at follow-up. The mean HbA1c decrease was 1.1%.
Conclusions
Though limited by sample size, our results suggest that medical STMM’s may have a clinically meaningful impact in chronic disease management when utilizing a systematic combination of education, medical therapy, clearly documented medication instructions and regular trip intervals.