Authors (including presenting author) :
Luk MH, Wong SN, Lai KPL, Fung HT, Chan PF
Affiliation :
Department of Family Medicine and Primary Health Care, Kowloon East Cluster (KEC)
Introduction :
With an aim to provide an easily accessible and infection control friendly clinical service to home isolated COVID-19 patients with mild to moderate symptoms, Teleconsultation Service was piloted in Hospital Authority (HA) in July 2022. The Teleconsultation Service had been established in KEC General Out-patient Clinics (GOPCs) since August 2022. Through HA Go app, teleconsultations were conducted by family physicians to assess the clinical conditions of home isolated COVID-19 patients. Medications including antivirals could be prescribed and then transferred timely to patients’ home on same day or next day by delivery service.
Objectives :
To evaluate the outcomes of teleconsultation service provided in KEC GOPCs to COVID-19 patients.
Methodology :
Relevant data of all patients who were seen by KEC Teleconsultation Service from 1 October 2022 to 31 October 2022 were retrieved from Clinical Data Analysis and Reporting System (CDARS). Relevant clinical information in Clinical Management System (CMS) was also reviewed.
Result & Outcome :
Results:
4,117 consultations were provided by KEC Teleconsultation Service in October 2022. Mean age of patients was 51.6 years old. Age range was 18 to 99 years old. 60.0% were female. Antiviral therapy was prescribed in 1,729 consultations (42.0%). Among these consultations with antiviral prescribed, 1,406 consultations were prescribed with Paxlovid (81.3%) and 323 were prescribed with Molnupiravir (18.7%). 29 and 13 patients were referred to COVID-19 Designated Clinics and Accident & Emergency Departments respectively for further assessment and management.
Subgroup analysis for patients of age 60 or above was performed, as these patients were at higher risk of developing COVID-19 complications and mortality. 1,431 consultations were provided for patients of age 60 or above. 57.2% were female. Antiviral therapy was prescribed in 1,083 consultations (75.7%). Among those consultations with antiviral prescribed, 837 consultations were prescribed with Paxlovid (77.3%) and 246 were prescribed with Molnupiravir (22.7%).
Reasons for antiviral therapy not prescribed for patients of age 60 or above were reviewed. The most common reasons included antiviral therapy were already prescribed before consultations (45.1%), symptoms onset was more than 5 days and therefore antiviral therapy was not indicated (30.2%), patient refusal (11.5%), and clinical condition required referral to Designated Clinics or Accident and Emergency Departments (7.8%).
Conclusion:
Family Medicine Teleconsultation Service provided a novel and accessible clinical service for COVID-19 patients, with timely delivery of antiviral therapy to patients’ home which could help reduce the development of severe COVID-19 complications and hospitalizations.
