Proposed Topic (Most preferred): :
Clinical Safety and Quality Service I (Projects aiming to improve efficiency and effectiveness of care delivery to meet international standards)
Proposed Topic (Second preferred): :
Clinical Safety and Quality Service III (Projects aiming at quality service to patients and their carers)
Authors (including presenting author) :
Ng shu wah (1), Chan Pui Fan (2), Fung Choi Kiu (2), Ngan Pui Ling (2), Tsang wai yi (2) Lee Chun Lung (2), Chan Si En (2), Tsui Miranda (2), Cheng Suet Lai (2), Cheung Pik Shan (2)
Affiliation :
(1) Nursing Service Division, United Christian Hospital (2) Department of Medicine & Geriatrics, United Christian Hospital
Introduction :
Asthma is a common chronic, heterogeneous condition affecting all age groups and is characterized by variable symptoms and variable airflow obstruction. The aim of asthma management is to gain disease control, and reduce future risk factors. The current management would focus on symptomatic control, exacerbation and decrease use of oral corticosteroid (OCS). However, for uncontrolled severe asthma who have frequent exacerbations with poor symptomatic control or are OCS-dependent would be considered for biologics therapy. A mechanism to care for adult patients with uncontrolled severe asthma who eligible for biologics has been established in an ambulatory care center of United Christian hospital.
Objectives :
To describe and review the care for adult patients with the uncontrolled severe asthma who receive biologics.
Methodology :
Eligible cases of severe uncontrolled asthma would be assessed and discussed regarding the treatment plan and, referred by Specialists in specialty outpatient department to medical day unit if patients agree. There is a mechanism to care of these uncontrolled severe asthma who eligible to receive biologics. The key components of care include: Patient registry Rechecking of treatment adherence, especially inhalation therapy Counselling and discussion on pathway, expected outcomes and potential adverse effects First dose of biologics arranged in a medical day unit Patient education of self-administration of subcutaneous injection of biologics by prefilled syringe or autoinjector at home via multi-visual aids e.g. leaflet, procedure checklist and video Demonstration and return demonstration with training checklist Empowerment on self-management plan
Result & Outcome :
Eleven eligible adult patients with uncontrolled severe asthma have received biologics since 2019 with mean age of 57.3 and 55% of male. Ten of them received pre-filled syringe or autoinjector for subcutaneous injection and were confident to administer by themselves after patient education. One year after receiving the biologics treatment, the number of course of OCS decreased by 44 % (7.5 to 4.2). Their symptoms were better controlled with higher score of asthma control test (ACT) by increase of 16.4% (14.6 to 17 over 25 on average). Conclusion There is mechanism in place to provide a structured and quality care for uncontrolled severe asthma cases who are eligible to receive biologics. They would decrease use of oral corticosteroid, have better symptomatic control and have less exacerbation after receiving the biologics. They are satisfied throughout the care process and confident to self-administer subcutaneous injection at home.
