Authors (including presenting author) :
FU TY(1), YUNK KL(1), TAM WO(2), Lam FM(2), KOO KF(2)
Affiliation :
(1) Department of Physiotherapy, Grantham Hospital (2) Tuberculosis and Chest Unit, Grantham Hospital
Introduction :
This program aims to integrate physiotherapy services into the chest clinic sessions for patients with chronic lung diseases. The goal is to streamline the care process, minimize travel burdens, and enhance patient empowerment in managing their condition through education and exercise training.
Objectives :
1. Integrated Care Delivery:
- Provide physiotherapy services concurrently with chest clinic appointments to save travel time and reduce the need for separate visits.
2. Patient Empowerment:
- Educate patients on disease management, chest clearance techniques, and exercise training to improve strength and overall function.
3. Comprehensive Patient Assess
- Physiotherapy assessment before consultations to provide physicians with a comprehensive view of each patient’s baseline function.
Methodology :
Patients with age > 65 years with chronic obstructive pulmonary disease (COPD) or bronchiectasis in the clinic were recruited. Physiotherapist provided 2 hours per week. The physiotherapy assessment included the degree of baseline functional disability by Modified Medical Research Council (mMRC), CAT questionnaire, subjective score of shortness of breath by modified Borg scale and single leg standing test. Followed by empowerment delivered.
Result & Outcome :
From 6 Mar to 30 Nov 2022, total of 43 patients recruited with 22 COPD (17 males (77%), 5 females (23%)); 21 Bronchiectasis (10 males (48%), 11 females (52%)). The mean age of COPD and Bronchiectasis were 67.1+/- 14.33 and 72.1+/- 7.68 respectively.
The mean score of mMRC of COPD and Bronchiectasis were 0.86+/-0.89 and 1.33+/-1.16 respectively. The CAT score of COPD and Bronchiectasis were
11.23+/-8.05 and 12.67+/-7.29 respectively. The modified borg scale of COPD and Bronchiectasis were 2.23 +/- 2.07 and 2.19+/-1.63 respectively. The single leg standing score of COPD and Bronchiectasis were 4.18+/-1.68 and 3.38+/-2.16 respectively which indicated high fall risk.
Positive feedback including reduced the need for multiple appointments and travel, patients received timely interventions and education, and with detailed functional assessments, doctors could make more informed decisions regarding treatment plans.
Conclusion
Integrating physiotherapy services within the chest clinic for chronic lung disease patients presents a valuable opportunity to improve care delivery. By providing comprehensive education and assessment in a single visit, the program streamlined the management of chronic lung diseases. Further evaluation of clinical outcomes will be essential for ongoing program refinement and success.