Authors (including presenting author) :
Dr Ho Tsz Bun, Dr Chan Yin Yue Yeni,Dr Chan Yin Hang,Dr Jun Liang, Dr Ng Yeung Shing
Introduction :
Introduction
Common wart is a common skin problem that affect hand and feet. Cryotherapy is an effective treatment to be considered when conservative treatment failed. However, the waiting time for Dermatology Specialist Outpatient Clinic (SOPC) of Department of Health was very long, and cryotherapy was not available in most of General Outpatient Clinic (GOPC). Availability of cryotherapy in Family Medicine Specialist Clinic (FMSC) can improved patient care and also reduce referral to SOPC.
Objectives :
Objective
New Service Model is developed to provide dermatological service to patients from Public primary care clinic (General Outpatient Clinic and Staff Clinic) and empowerment of the primary care doctors to develop special skills of cryotherapy.
Methodology :
Methodology
A structure program of cryotherapy for common warts was piloted since 2021. The target patients are adult who attended GOPCs and Staff Clinic in Tuen Mun District for common warts and agreed to consider cryotherapy as treatment options. They were referred directly to FMSC for management. They were assessed and managed by family doctors. Cryotherapy were performed by junior doctors under the supervision of family physician specialist. All patients who had undergone the procedure were followed up for outcome evaluation.
Result & Outcome :
Result and Outcome
From March 2021 to Dec 2022, 24 patients (8 males and 18 females, age range from 16 to 82) were referred from the pilot primary care clinics (GOPC and Staff clinic). They were assessed by family physicians, and cryotherapy would be provided within 3 to 6 weeks after initial assessment.
18 (75%) of patients had received cryotherapy and no complication were reported. All of them showed improvement in outcome. More than 80% (15/18) of patients had wart resolved within 3 sessions of cryotherapy. Patients who did not have cryotherapy were either having atypical feature or wart locating at site not suitable for cryotherapy. Eight FM trainees have the hand on experience and hence build up the skill to provide cryotherapy.
Conclusions
This pilot program demonstrated that cryotherapy for common warts could be effectively performed by family doctors. Family doctors could be empowered to perform dermatological procedure with adequate training. This could significantly reduce the number of referrals to Dermatological SOPCs and improve the quality of care to our patients.
