Proposed Topic (Most preferred): :
Clinical Safety and Quality Service I (Projects aiming to improve efficiency and effectiveness of care delivery to meet international standards)
Authors (including presenting author) :
Luk MHM, Lai KP, Chan PF
Affiliation :
Department of Family Medicine and Primary Health Care, United Christian Hospital and Tseung Kwan O Hospital, Kowloon East Cluster
Introduction :
Since year 2010, the intranet website of Department of Family Medicine and Primary Health Care in Kowloon East Cluster has featured more than 20 clinical calculators to support our frontline doctors on evidence-based practice and improve patient care quality. With the update of international lipid management guidelines and the implementation of family physician led Chronic Hepatitis Clinic in the Department, these tools had been refreshed to assist our doctors in managing hyperlipidemia and chronic hepatitis B more efficiently and effectively.
Objectives :
To review and update the clinical calculators at our Department’s intranet website for guiding our family medicine doctors on evaluation and treatment of hyperlipidemia and chronic hepatitis B.
Methodology :
Evidence-based clinical guidelines on hepatitis B and hyperlipidemia were recently updated by our Department's senior family medicine specialists in June 2023 and August 2023, to guide and align clinical practice in our primary care clinics. Clinical calculators in our Department's website, based on these clinical guidelines, were revised with their functions expanded to aid our family physicians in practicing evidence-based medicine when following these clinical guidelines.
Result & Outcome :
Results:
Chronic hepatitis B-related clinical calculators had been updated, including:
1. Combining the AST to Platelet Ratio Index (APRI) and the Fibrosis-4 (Fib-4) score into a single calculator to avoid repetitive entry and improve efficiency when calculating the risk of liver fibrosis and cirrhosis for chronic hepatitis B patients.
2. The Child-Pugh calculator was added to help family medicine doctors assess the prognosis of patients with liver cirrhosis.
Hyperlipidemia-related clinical calculators have been updated, including:
1. The Joint British Societies (JBS) cardiovascular risk calculator had been updated to include the suggested low-density lipoprotein cholesterol (LDL-C) target calculation.
2. A calculator for determining the minimum cholesterol target had been added for patients with diabetes mellitus and established atherosclerotic cardiovascular disease.
3. The Dutch Lipid Clinic Network Score (DLCNS) calculator was added to assess the likelihood of familial hyperlipidemia.
Conclusion:
Together with the corresponding evidence-based practice guidelines on hepatitis B and hyperlipidemia in our website, the updated clinical calculator platform could help family medicine doctors make evidence-based clinical decisions more accurately and efficiently.
