Authors (including presenting author) :
Chow KL, Lai KPL, Chan PF, Lam MY, Chao DVK
Affiliation :
Department of Family Medicine and Primary Health Care, United Christian Hospital and Tseung Kwan O Hospital, Kowloon East Cluster
Introduction :
COPD is a major cause of morbidity and mortality. Patients with COPD were recommended to receive influenza and pneumococcal vaccines to prevent severe COPD exacerbation and chest infection requiring attendance to Accident & Emergency Department or hospitalization due to influenza and pneumococcal infection. Reducing the admission rate of COPD patients is important to relieve the burden in secondary care especially during winter surge.
Objectives :
To review the vaccination rates [Seasonal influenza vaccine (SIV), 23-valent pneumococcal polysaccharide vaccine (23vPPV) and pneumococcal conjugate vaccines (PCV13)] and compare the admission rates in COPD patients with or without receiving vaccinations in a GOPC in past one year.
Methodology :
All COPD cases being followed in Tseung Kwan O Jockey Club (TKO JC) GOPC from 1st October 2018 to 30th September 2019 were included. Data were retrieved from the Clinical Management System to review the vaccination status and the presence of admissions due to COPD exacerbation.
Result & Outcome :
225 patients with COPD attended TKO JC GOPC for follow up during the study period. 90.9% patients were male. The mean age was 74.0 years old. The vaccination rate of SIV, 23vPPV and PCV13 were 77.6%, 66.7% and 70.9% respectively. The admission rates due to COPD exacerbation were significantly lowered in patients received SIV (11.7% vs 32.4% in patients who did not receive SIV, p=0.003), 23vPPV (8.2% vs 32.7% in patients who did not receive 23vPPV, p< 0.001), PCV13 (8.5% vs 35.4% in patients who did not receive PCV13, p< 0.001) and SIV and either pneumococcal vaccines (10.9% vs 27.3% in patients who did not receive SIV and either pneumococcal vaccines, p=0.007). The admission rate was the lowest in patients receiving all 3 vaccines (6.3% vs 30.4% in patients did not receive any vaccine, p< 0.001). SIV, 23vPPV and PCV13 can effectively reduce the admission rate due to COPD exacerbation in patients with COPD being followed in primary care. High vaccination rates for patients with COPD could be achieved in GOPC and should further be reinforced.
