Authors (including presenting author) :
CHAN G(1), TSANG G(1), TONG M(2), CHAN E(1), WONG T(1), YEUNG J(1), KWONG S(1), WAN S(1), LAM D(2), LO E(2), SO L(2)
Affiliation :
(1)Physiotherapy Department, Pamela Youde Nethersole Eastern Hospital, (2)Department of Medicine, Pamela Youde Nethersole Eastern Hospital
Introduction :
Pulmonary rehabilitation programme (PRP) was proven to be effective in reducing readmission rate of chronic obstructive pulmonary disease (COPD) patients. In Hong Kong East Cluster (HKEC), Ruttonjee Hospital (RH) and Tung Wah Eastern Hospital (TWEH) provide PRP for COPD patients. However, there are several barriers for patients to participate the formal PRP such as finance, geographic reason or being not aware of the importance of PRP. Apart from the triage service by physiotherapists, physiotherapists in PYNEH also provided exercise training and education to COPD patients.
Objectives :
1. Maximize the utilization of resource in HKEC PRP by increasing number of patients receiving pulmonary rehabilitation 2. Reduce time to first attendance of pulmonary rehabilitation 3. Reduce readmission 4. Improve functional capacity in COPD patients
Methodology :
COPD patients admitted to acute medical wards were triaged by physiotherapists. They were referred to RH/TWEH PRP or PYNEH out-patient according to patients’ preference and need. For those referred to PYNEH out-patient and completed training, they were either referred to RH/TWEH PRP or discharged with home exercise.
Result & Outcome :
103 patients were screened and recruited from Sept 2016 – March 2021. In addition to 36 cases referred to RH/TWEH PRP, 67 patients (around two-third of total cases) were recruited to PYNEH exercise training. 15 out of 47 patients were referred to RH/TWEH PRP after completion of training in PYNEH. RH/TWEH PRP was suspended in 2020 due to COVID-19. Meanwhile, 5 cases attended PYNEH out-patient, which continued to serve those patients in need. Altogether 70/103 patients attended RH/TWEH PRP or PYNEH exercise training. The mean time to first attendance were 9.14 days in PYNEH, 19 days in RH and 24.2 days in TWEH. The 28-day readmission rate of patients attending training, when compared to that non-attendance, was decreased by 17.9%. In those who completed training in PYNEH in 2019 (n=12), there was improvement in mean distance of 6-minute walk test by 17 meters. The mean COPD Assessment Test (CAT) score reduction was 3.3 in these patients, reaching the minimal clinically important difference. Conclusion: PRP triage programme and exercise training in PYNEH enhanced the coverage of rehabilitation in COPD patients and reduced the waiting time. Patient benefited from this programme with reduction of readmission rate and improvement in functional capacity.
