Authors (including presenting author) :
Ms Lai FS, Mr Leung SH, Dr Li YC, Dr Ko SH
Affiliation :
Department of Family Medicine and Primary Healthcare, Kowloon Central Cluster
Introduction :
Confronting chronic disease in our community, Asthma and Chronic Obstructive Pulmonary Disease (COPD) remains a significant public health challenge which result from smoking and environmental condition. Timely assessment and treatment benefit to patient daily life quality and disease maintenance. Health education and inhaler use can enhance the compliance of medication.
Methodology :
Besides COPD, the Nursing and Allied Health Clinic - Respiratory Disease (NAHC-RD) program has been expanded to include adult asthma patients since 2023.
Staff Training:
The nurses were trained and designated assessment tool and forms were selected to provide more information for doctor treatment planning. In-house training for on diagnosis, treatment, and management in accordance with evidence-based guidelines. Knowledge can raise awareness among health care providers of the prevalence, impact, and challenges related to disease management. The inhaler using skill and tips have been taught. A written informational drug usage sheet will be given to patient.
Alignment of assessment tools and forms:
Asthma Control Test (ACT) has been recognized and is widely used as a tool to assess and monitor asthma control in clinical settings. ACT scores helps health care providers and patients evaluate the level of asthma control and make adjustment to treatment plans. Peak flow rate (PFR) is a sample test and is a valuable measurement in the management of asthma. Whereas COPD, the CAT and mMRC will be adopted as assessment.
Designed forms and nursing template for all nurses are used for communication and document. A written informational drug usage sheet will be given to patient.
Result & Outcome :
From 6/2023 to 12/2024, a total of 122 patients were recruited with 51 Asthma and 71 COPD cases. Prior to the consultation, patients were assessed for their respiratory status over the past 2-4 weeks. After doctor consultation, medication adjustment and patient education, there was improvement on patient condition.
The ACT score greater than 20 increased from 44% to 59%, with 14% of patients with a score of 25. And the proportion of patients with poorly controlled asthma (score below 15) decreased from 10% to 5%.
For COPD, the CAT score and mMRC score had been improved that COPD grouping from B to A (>40 %)
Before patient education, a large proportion of patients (69%) had PFR readings is below the predicted value, and only 31% of patients who had PFR readings above the predicted value. The patient PFR improved slightly, and the predicted value greater than patient PFR increased from 31% to 38%.
Besides, the inhaler technique was improved after education with demonstration.
According to assessment data, it was shown the proper assessment and education had a positive impact and improvement on patient respiratory condition.
