Authors (including presenting author) :
Siu DCH(1), Ng APC (1), Ngai AYY(1), Chang VSP(1), Poon DWF (1)
Affiliation :
(1)Occupational Therapy Department, Prince of Wales Hospital, NTEC
Introduction :
Chronic Obstructive Pulmonary Disease (COPD) is a common diagnosis associated with hospital readmission (Chan et al., 2011). Poor management of COPD and acute exacerbation (AECOPD) may lead to an increased number of unplanned medical consultations and serious hospital admission and causing death. The infectious disease pandemic, including COVID-19, restricted access to care, worsened the health and function of people with COPD in Hong Kong. Excessive health stress or infection worries led to isolation and physical inactivity. It could be harmful to one’s well-being, leading to serious health problems such as the increased risk of chest infection, depression, anxiety, and somatic symptoms (Inter-Agency Standing Committee, 2020). Occupational Therapists(OT) are dedicated for empowering patients with COPD to live their life to the fullest by adopting various treatment approaches, including dyspnea and fatigue management.
Objectives :
1. To develop a pilot hybrid telehealth OT self-management program for patients with COPD and recent exacerbation history 2. To study patient satisfaction and feasibility for further development 3. To compare the effectiveness of telecare and face-to-face format in delivering OT service
Methodology :
Patients with recent AECOPD were invited to join the pilot telecare COPD self-management program with OT intervention from April 2020 to September 2021. Patients were reviewed after 6 months of the intervention. After discussion with patients, caregivers, and expert panels in pulmonary rehabilitation, a hybrid telecare format was confirmed. The training program was delivered with a combination of face-to-face training and live broadcasting via electronic platform, including HA Go, Zoom, and WhatsApp. Patients received six 1.5 hours training sessions with program including "Chinese version of Living Well with COPD" and Health Qigong (BaDunJin). They needed to attend outpatient services before and after the program for functional assessment and electronic device setup. Patients in the traditional face-to-face and hybrid telecare groups received the same training content, session and duration as conventional group.
Result & Outcome :
Seven patients were recruited to the program with recent hospital admission due to AECOPD. Two patients agreed to join the hybrid Telecare COPD Care Program with caregivers. Five patients completed the program in the traditional face-to-face format. Both hybrid telecare COPD program and face-to-face showed a significant reduction in number of AECOPD in the past 12 months compared with the baseline. All patients satisfied with the hybrid telecare format arrangement to reduce their stress and enhance care access under the COVID-19 pandemic.
Conclusions
Improved clinical outcomes were identified in both hybrid telecare and conventional intervention group, such as functional outcome in C-MRADLQ and quality of life in CCRQ. Key factors were identified for successful implementation and the next stage of enhancement, such as patient’s health literacy, availability of electronic devices, components of training and support from caregivers for further program implementation.
