Authors (including presenting author) :
Kan YS(1), Siu DCH(2), Cheung TYM(3), Lee CCP(1), Leung MKW(1), Leung KWK(1), Leung SY(1), Wong PK(1), Chiu CWH(1), Hui EMT(1), To CYL(3), Poon DWF(2), Hui E(1)
Affiliation :
(1)Department of Family Medicine, New Territories East Cluster,(2)Department of Occupational Therapy, Prince of Wales Hospital,(3)Department of Physiotherapy, North District Hospital
Introduction :
Patients with chronic obstructive pulmonary disease (COPD) are at high-risk of developing acute exacerbation during winter surge leading to increased AED admissions, which causes great burden to hospitals.
New Territory East Cluster (NTEC) Nurse and Allied Health Care Respiratory management programme (NAHC RESP) team in General Out-Patient Clinics (GOPCs) have run an empowerment programme in this winter surge to keep COPD patients in their optimal conditions in the community in order to minimize the risk of AED attendance and admission. The programme had been piloted in 2017/2018 with obvious benefit in reducing AED attendance related to respiratory symptoms.
Objectives :
The objectives are to empower COPD patients to maintain their optimal health condition in the community by: 1. Promoting the uptake of seasonal influenza & pneumococcal vaccinations; 2. Empowering patients’ ability in self-management of COPD in winter surge.
Methodology :
The empowerment programme was conducted in five GOPCs in Shatin, Tai Po and North district from 28th October 2019 to 31st December 2019. All COPD patients ever attended medical consultation in NTEC GOPC were invited by NAHC RESP team via phone call or by mail to join the programme.
The programme consists of three components (1) prevention of influenza, (2) empowerment on management of COPD, (3) provision of a support hotline. The patients were encouraged to receive influenza and pneumococcal vaccination. Education classes were held to reinforce knowledge on personal hygiene, vaccination, self-monitoring of symptoms, crisis pack education and inhaler puff technique. A support hotline was set up to triage COPD patients with worsened symptoms for early medical consultation.
Result & Outcome :
2,206 COPD patients under the catchment of NTEC GOPCs were invited to join the empowerment programme and 794 patients attended. Up to 31st December 2019, there was an increase in seasonal influenza vaccination from 908 (2018/2019) to 1,004 (within 10 weeks in 2019/2020). 285 patients (26.2%) in those COPD patients without vaccination history in 2018/2019 have received vaccination (Chi-square =525.44, p< 0.001). The avoidable AED admission related to worsen respiratory symptoms was reduced by 5% when compared with 2018/2019. 23 hotline calls were received with early medical consultation arranged in 70% of the calls. Majority of COPD patients were satisfied with this programme and were willing to re-join in 2020/21.
In conclusion, the targeted empowerment programme could promote seasonal influenza and pneumococcal vaccination, enhance health awareness, strengthen knowledge on COPD management, and reduce AED attendance due to worsened respiratory symptoms during winter surge.
