Authors (including presenting author) :
Chow MC(1), Choi TL(1), Lo BYE(1), Lam YF(1), So KYL(1)
Affiliation :
(1)Department of Medicine, Pamela Youde Nethersole Eastern Hospital
Introduction :
Adherence to medication has been implicated as an important factor affecting therapeutic efficacy to COPD patients. A telephone programme was set up to line up trained volunteers and health care workers to empower COPD patients in drug compliance.
Objectives :
To evaluate the effectiveness of a telephone programme in COPD patients’ self-management and reducing readmission rate.
Methodology :
Three volunteers were recruited from Patient Resources Center to receive a series of four one-hour educational lectures by respiratory nurse specialists in several aspects of COPD: physiology and pathology, common symptoms and coping strategies, importance of medication adherence, smoking cessation and vaccination. Instruction sheets and checklists were provided to the volunteers.
The trained volunteers made, not less than ten, phone calls to patients once every two weeks for twelve months. Volunteers directly contacted Respiratory nurse specialists for providing ad hoc telephone consultation service, fast-track appointment to specialists’ clinic, drug refill, organization of vaccination and home-help services if necessary. At twelve months post-implementation, a structured telephone survey was conducted for effectiveness.
Result & Outcome :
95 COPD patients were recruited from 2017 to 2019. 62 patients (65%) completed the programme and data collection. Drop out were mainly due to disease trajectory. All successful candidates were satisfied with the programme and found it useful in coping with their illnesses at home. They showed improvement in percentage of correct medication dosage (81.9% to 95.8%) and frequency (82.7% to 94.2%). They had better compliance to the use of spacers for inhaled medications (91.7% to 100%) and became more willing to wash spacers regularly (89.2% to 100%). With telephone support, patients had reduced emergency department attendance (1.56 to 0.81 visit/patient) and reduced hospital admissions (1.37 to 0.62 admission/patient). The total length of hospital stay reduction (5.73 to 2.72 days/patient) was found coincidentally in the programme.
Our empowerment telephone programme by trained volunteers improved COPD patients drug adherence and readmission rate.
