Authors (including presenting author) :
TUNG YM(1), OR YL(1), LAW SC(1), TSE WF(1), WONG TH(1), LAM SW(1), TUNG HYA(2), TUNG KYJ(2)
Affiliation :
(1) GI Team, Department of Medicine and Geriatrics, Kwong Wah Hospital
(2) Medicine, CUHK
Introduction :
Upon the COVID-19 global pandemic started in early 2020, many elective procedures done in public hospitals have been stopped. On one hand, hospital infection control team has to reduce patient activities inside clinical area in order to reduce risk of infection. On the other hand, being the clinical service provider, we have to ensure patient’s health can be managed efficiently without much delay of various medical investigations due to cessation of elective procedures. Urea Breath test , is a commonly used investigation to test the presence of Helicobacter Pylori inside patient’s stomach. This is an important test to ensure eradication of Helicobacter Pylori so as to reduce patient risk of developing peptic ulcer. The use of UBT can also reduce the heavy demand of elective upper endoscopy , which was also stopped during the COVID-19 emergency response. This test is usually done in clinic or as a ward procedure. Patient is asked to exhale breath into a collection bag. He/she is then asked to drink a dissolved non-radioactive C13 tablet. Patient is then asked to collect another breath into a bag for laboratory analysis. The procedure takes around 45 to 60 mins and patient has to take off their mask during drinker and exhaling during this examination.
Objectives :
Since KWH is now under redevelopment project and we have space limitation, as well as two of our emergency medical wards were converted to surveillance wards. In order to reduce patient’s risk of COVID-19 infection during their stay in clinic or ward area, an unprecedented way of home urea breath test was started in our medical unit. This also aim at enhancing patient acceptance to reduce default rate for this investigation.
Methodology :
Patient is prescribed with C13 Urea tablet when the UBT request was made in GCRS. Our GI Team nurses pre-recorded a video instruction about the whole procedure. Patient will then be given written, as well as video instruction through their smartphone. Patient then collect two breath collection bags, as well as the C13 tablet from pharmacy. Phone call support will be given and patient can make the C13 urea drink and then collect their breath at home. The collected breath bags are then brought back by patients or their relatives through a drop-box in non-clinical area. Upon completion of the breath bags collection, telephone questionnaire will be conducted to evaluate patient acceptance and satisfaction regarding this new way of clinical service.
Result & Outcome :
A total of 110 UBT tests were done at home during the 3 months period. The overall rate of positive test for Helicobacter Pylori was 10% . Patient default rate was zero and overall patient satisfaction rate was over 99%. We believe we are the first hospital in Hong Kong to implement this home UBT procedure. Patient can perform the procedure safety at home with high patient acceptance and satisfaction.
