Proposed Topic (Most preferred): :
HA Young Investigators Session (Projects to be presented by HA staff who had joined HA for 10 years or less)
Proposed Topic (Second preferred): :
Clinical Safety and Quality Service III (Projects aiming at quality service to patients and their carers)
Authors (including presenting author) :
Leung LYK(1)(2)
Choi WL (3)
Tam YT (2)
Affiliation :
(1) Department of Pharmacy, Caritas Medical Centre (2) Department of Pharmacology and Pharmacy, The University of Hong Kong (3) Department of Pharmacy, United Christian Hospital
Introduction :
Achieving a good asthma control in paediatric patients requires healthcare professionals’ thorough understanding of their condition and a frequent follow up on their progress so timely adjustment can be made. It is known from literature that those who are newly diagnosed or newly started on medication requires additional support. The service model at the hospital under this study currently reviews paediatric asthma patients’ disease control every 3-5 months. Providing telepharmacy service to achieve a more frequent follow up may maximize the clinical benefit to the patients.
Objectives :
To demonstrate the positive impact of adding telepharmacy session(s) to regular pharmacist clinic sessions on paediatric asthma patients’ disease activity and the quality of life in those aged between 7-17.
Methodology :
An open label, randomized controlled study was conducted. 24 subjects were randomized to either the intervention group with extra telepharmacy session(s) or the control group with only regular face-to-face clinic visits. The primary endpoint included firstly the change in peak expiratory flow rate measured by peak flow meter, secondly the change in asthma control test score measured using the questionnaire completed by the subjects and caregivers, and lastly the change in caregiver’s knowledge, attitude and practice score on asthma using the questionnaire completed by the caregivers. The secondary endpoint was the patient’s quality of life measured by the Paediatric Asthma Quality of Life Questionnaire in subjects aged between 7-17 years old. The data were analyzed using IBM SPSS software. For categorical variables such as age and gender, chi-square test of association was used while for continuous variables such as mean score, Mann-Whitney U test was applied. Numbers are considered statistically significant if p<0.05.
Result & Outcome :
The mean asthma control test score increased for 1.8 for the intervention group and 0.7 for control group (p = 0.26). The mean childhood asthma control test score increased for 2.4 for the intervention group and 0.5 for control group (p = 0.47). The total mean knowledge, attitude and practice score improved for 1.73 for intervention group and 1.24 for control group (p=0.40). When looking into the individual domains, the intervention group also had larger percentage increase in score when compared to the control group, albeit not reaching statistical significance. The change in peak expiratory flow rate was the only primary outcome that reached statistical significance. The reading improved for 16.37 for intervention group and 11.54 for control group (p=0.04). For secondary outcome, the intervention group achieved a higher increase in total mean quality of life score. They also performed better than the control group in all the three domains of the questionnaire, namely activity limitations, symptoms and emotional function. Only emotional function domain achieved a statistical significance improvement (p=0.04).
