Authors (including presenting author) :
Wong MK(1), Leung LM(1), Lam KF(1), Ng YS(1)
Affiliation :
(1)Department of Family Medicine and Primary Health Care, NTWC, Hospital Authority
Introduction :
Chronic Obstructive Pulmonary Disease (COPD) is a preventable respiratory condition characterized by persistent airway obstruction. Early diagnosis is crucial for effective management. Spirometry is a key tool that helps primary care providers assess lung function and identify COPD in at-risk patients. However, services were temporarily halted due to the COVID-19 pandemic and have just fully resumed since April 2023.
Objectives :
To identify patients with COPD.
To improve outcomes and quality of care of COPD.
Methodology :
The Chronic Lung Disease Management workgroup at the Department has developed a Nurse Clinic Protocol for COPD care. This protocol promotes evidence-based practices to enhance outcomes, including spirometry, GOLD disease staging, COPD Assessment Test (CAT) dysnoea tool, medication optimization, inhaler education, Smoking Cessation Counseling Service (SCCC) with explanation of lung age and provision of COPD information cards, which serve as permit for Ad hoc doctor consultation in case of increasing symptoms. Doctors at Tin Shui Wai Health Centre (Tin Shui Road) referred patients with risk factors and symptoms such as shortness of breath or chronic cough for suspected COPD. Advanced Practice nurse performed the spirometry assessments.
Result & Outcome :
A retrospective analysis was conducted from 11/5/2023-28/11/2024. 62 patients were referred for spirometry. 27.4% (17/62) were female and 72.6% (45/62) were male. Range of age was 25 to 88 years old. 32.3% (20/62) was ex-smoker, 37.1% (23/62) was smoker and 30.6% (19/62) was non-smoker.
40.3% (25/62) were obstructive, 41.9% (26/62) were normal, 6.5% (4/62) were restrictive, 6.5% (4/62) were mixed obstructive and restrictive, 4.8% (3/62) failed. So, 46.8% (29/62) were diagnosed with COPD. Among the obstructive cases, 24% (6/25) were in GOLD Stage one, 52% (13/25) were in Stage two and 24% (6/25) were in Stage three. Patients received appropriate medications afterward.
Of the 23 smokers, 56.5% (13/23) attended SCCC in which 38.5% (5/13) quitted smoking.
100% (29/29) COPD cases received flu vaccine and 55.2% (16/29) received pneumococcal vaccine.
The average lung age of patients with COPD was 87.7. CAT average scores were 9.7/40. Following the protocol, five COPD information cards were provided. Ad hoc doctor consultation for patients with COPD was zero.
Conclusion
The review highlighted spirometry's key role in diagnosing COPD across demographics and ruling out normal lung function in symptomatic patients. This could improve patients’ quality of life and prevent disease progression, informing future policy to COPD empowerment program and patient resource center collaboration.
