Proposed Topic (Most preferred): :
Research and Innovations (new projects / technology / innovations / service models)
Proposed Topic (Second preferred): :
Clinical Safety and Quality Service III (Projects aiming at quality service to patients and their carers)
Authors (including presenting author) :
Lau WM(1), Lam HY(1), Ho WK(1)
Affiliation :
(1) Tuen Mun Alcohol Problem Clinic, Castle Peak Hospital
Introduction :
Patients with alcohol use disorders (AUDs)who have completed in-patient detoxification treatment for alcohol, despite having a strong motivation to keep abstinence, may still face risk of relapse during maintenance stage due to multi-faceted and complex risk factors such as psychological craving. Evidence-based studies recommended a combination of behavioral intervention and pharmacological treatment for relapse prevention (RP) from drinking. The provision of supportive counselling with clinical supervision for taking RP drug -Disulfiram – in Tuen Mun Alcohol Problems Clinic (TMAPC) helps patients to achieve total abstinence. Generally, patients are supervised by either face-to-face clinic nurse in TMAPC or care-givers at home. Due to COVID 19 pandemic, some patients faced barriers in turning up TMAPC to take Disulfiram. To tackle the problem, we have been implementing live “face time” on smart phone, namely Telehealth, to remotely supervise patients’ Disulfiram taking with supportive counselling since 1Q2022. As a snapshot from May 2023, a total of 20 out-patients are taking Disulfiram, with 7 being supervised through Telehealth. The 7 out-patients are all males, aged from 37 to 71, diagnosed Alcohol Dependence Syndrome (ADS) whilst 3 of them co-morbid with Depression. Their pre-program daily alcohol consumption varied from 4 alcohol units to 24 alcohol units.In this project, we focus to evaluate the effectiveness of Telehealth in providing clinical supervision and supportive counselling for the 7 patients receiving Disulfiram.
Objectives :
1) Increase accessibility of pharmacological relapse prevention treatment to patients 2) Ensure continuity of combined nursing care in supervising and counselling patients in drug taking through Telehealth during COVID 19 pandemic 3) Help patients abstain from alcohol during maintenance stage
Methodology :
Before implementation: 1) patients are assessed for suitability to take Disulfiram and they agree to use Telehealth for clinical supervision with signed consent. Nursing advice with written medication notice was provided to patient. 2) Patient education rendered by clinic nurse on how to use Telehealth function on their mobile phones and protection of data privacy and confidentiality 3) Briefing was conducted to clinic nurses regarding the logistics and technology back-up required for clinical supervision via Telehealth During implementation: 1) Patient phones in by using “face time” feature on smartphone. Clinic nurse observes patient taking Disulfiram with log sheet recorded. Supportive counselling is rendered by clinic nurse. Evaluation of outcome measures: 1) to compare patients’ alcohol daily consumption at pre and during implementation; 2) to understand patients’ satisfaction level with this program
Result & Outcome :
1) The alcohol daily consumption of all 7 patients was 0 alcohol unit during the program. The treatment goal of total abstinence is achieved. These improvements can be attributed to the patients' consistent adherence to the disulfiram treatment.
2) The satisfaction survey obtained positive feedback from all patients, indicating a high level of acceptance for service delivery by telehealth mode. All 7 patients strongly agreed telehealth mode enhanced their accessibility to this RP drug that directly helped them to abstain from alcohol.
