Authors (including presenting author) :
Fung HT, Lai KPL, Too LC, Wong SN, Wong TK, Chan PF, Chao DVK
Affiliation :
Department of Family Medicine and Primary Health Care, United Christian Hospital and Tseung Kwan O Hospital, Kowloon East Cluster
Introduction :
In 2016/17, a total of 11,190 COPD patients were managed by GOPCs and amongst them 12% required admissions due to COPD exacerbations. COPD exacerbations are burdensome both to patients and to health care services. The risk of COPD exacerbations can be reduced by vaccinations against influenza and pneumococcus and smoking cessation. In order to enhance the quality of care of COPD patients and reduce their risk of exacerbations, a clinical audit was carried out in all GOPCs by the Quality Assurance Subcommittee of Coordinating Committee of Family Medicine in 2017/18.
Objectives :
To review the patient outcomes after implementing a series of measures to enhance the seasonal influenza vaccine (SIV) and pneumococcal vaccination rate, and the utilisation of smoking cessation service of COPD patients in KEC GOPCs.
Methodology :
The following interventions were implemented in KEC GOPCs since 2017: 1. Promotion of SIV and pneumococcal vaccinations including the use of reminders in Clinical Management System; 2. Update of clinical guidelines on COPD management; 3. Conduction of smoking cessation audit in some KEC GOPCs; and 4. Periodic review of the audit outcomes in operational meetings. The vaccination rates of SIV and pneumococcal vaccine, the attendance rate of smoking cessation service among smokers and the admission rates due to COPD exacerbations of COPD patients attending KEC GOPCs from 2016/17 – 2018/19 were retrieved.
Result & Outcome :
1801 and 1597 patients were included in the 1st cycle (2016/17) and 2nd cycle (2018/19) respectively. After the implementation of interventions, the vaccination rates of pneumococcal and SIV were significantly improved from 39.4% to 54.7% and from 45.4% to 49.3% respectively. The attendance rate of smoking cessation service was also improved from 44.8% to 51.6%. Moreover, the admission rate due to COPD exacerbations dropped from 8.7% to 8% (vs 10.3% of all GOPCs). Conclusion: With the implementation of a series of measures in enhancing COPD management, we were able to reduce the admission rate of COPD patients in KEC GOPCs.
