Authors (including presenting author) :
WONG LF(1), LI CML(1), LAW MS(1), WONG HK(1), WONG MC(1), CHUNG SL(1), WAN LS(1), NG SW(2), CHOY CF(1)
Affiliation :
(1) Respiratory Specialty, Department of Medicine, Tseung Kwan O Hospital,(2) Nursing Service Division, United Christian Hospital
Introduction :
Chronic Obstructive Pulmonary Disease (COPD) remains a major healthcare challenge worldwide. Between 2019 and 2021, COPD unplanned readmission rates in the Hospital Authority (HA) ranged from 30% to 38%. At Tseung Kwan O Hospital, 622 COPD-related admissions were recorded in 2022.
To address this issue, Post Exacerbation Empowerment Program (PEEP) was introduced at the Ambulatory Medical Centre (AMC) in June 2023. This structured nine-week less intensive program is designed to empower COPD patients through self-management skills. Patients attend sessions at Weeks 0, 2, 4, and 8, aiming to reduce hospital readmissions and improve overall outcomes.
Objectives :
(1) To evaluate whether a short multidisciplinary program for post-acute exacerbation of COPD reduces hospital readmissions and the length of stay (LOS)
(2) To explore whether such a short program improves the daily lives of patients with COPD
Methodology :
A retrospective study was conducted to assess the effectiveness of PEEP. Eligible COPD patients were recruited from medical wards, while those who had completed PEEP within the previous year were excluded.
Result & Outcome :
From November 2023 to October 2024, 105 patients were enrolled in PEEP (mean age 73; 92% male). By October 2024, 70 patients had successfully completed the program.
There was statistically difference in mean LOS for PEEP group (mean LOS = 4.49 days, SD ± 4.68) and non-PEEP group (mean LOS = 7.21 days, SD ± 11.02; t (548) = 2.49, p=0.013, 2 tailed). Similarly, the unplanned readmission rate was 23% in the non-PEEP group versus 11.5% in the PEEP group. This retrospective analysis demonstrated that PEEP significantly benefited COPD patients.
There was a statistically significant decrease in COPD Assessment Test (CAT) scores among PEEP participants, from a mean of 9.95 (SD ± 5.15) at Week 0 to 7.87 (SD ± 6.17) at Week 8 (p<0.003, 2-tailed). The mean reduction in CAT scores was 2.08, with a 95% confidence interval ranging from 0.712 to 3.46.
This retrospective study highlights PEEP as an effective intervention for COPD patients, reducing hospital stays, lowering readmission rates and improving symptom management. Additionally, PEEP enhances patients’ quality of life by promoting self-management skills and better daily functioning.
