Authors (including presenting author) :
Lo HYE(1), Cheung PHJ(1), Wong YW(1), Chan MY(1), Mui CM(1), Ling PC(1), Leung SM(1), Chan CHK(1)
Affiliation :
(1)Department of TB & Chest, TWGHs Wong Tai Sin Hospital
Introduction :
The initial educational follow-up within first month plays an importance role in patient’s adherence and compliance of using CPAP (La Piana et. al., 2011). According to the Ozlem A. and Sarac S. (2023), phone follow-up is the essential tool for telemedicine monitoring. Therefore, from 2011, Phone follow-up by WTSH sleep lab for OSA patients on CPAP compliance was established. This service is mainly provided by nurses in 4A ward. In average, there were around 80 cases per month that recruited. The main disadvantage of this program is that these 80 cases were shared by 4 to 5 nurses, which means that each nurse need to provide over 20 phone follow up in each month. However, each successful phone call needs 10 to 20 minutes. Almost all patient will not answer our first call, we often need to call them twice or more. Therefore, it is a total time consuming program, in the era of manpower shortage, it makes the nurse decrease compliance to implement this program. However, recent journal suggested that positively framed messages can improve CPAP adherence in patients with OSA in the short-term (Pengo et. al., 2018). Therefore, from 2023 June, we had started up a new Follow up program through Social message software. This program is mainly target for sleep patients newly use PAP machine
Objectives :
1. To increase OSA patients on compliance of CPAP trial. 2. To increase patient’s knowledge in Sleep education especially in CPAP usage. 3. To assist patient to solve common problems encountered when using PAP therapy. 4. To save time for follow up.
Methodology :
1. A logbook (appendix A) is used to record newly-use PAP machine patient’s particulars especially mobile phone number and discharge date. 2. In log book, enter HN no. (number in red color) instead of patient real name because of patient privacy issue 3. For each newly use PAP machine patient, a pink notice (appendix B) will be attached on the next appointment slip before discharge that there will be Social message software message from Hospital mobile to ask their PAP using status. 4. RPSGT will send pre-texted warm-reminder through Social message software to patient 1 week upon discharge. 5. RPSGT will send pre-texted message through Social message software to these patients 1 month after discharge date (To provide adequate time for patient to install PAP machine.) 6. If patient does not response to the first message, a second identical message will be sent to he or she one month later. 7. English and Chinese message templates (appendix C) were already saved in the sleep lab mobile phone, therefore no need to type in the message every time. 8. If patients have common problems, solution templates should be sent via Social message software accordingly. 9. If patient have some complicated problems, a general reply template will be sent by telephone. So if these patient had call us, we will mark it down in CMS (nursing note) for record instead of patient record in his or her IMR to increase the accessibility. 10. RPSGT/APNs will responsible for the follow up for one-month period and continue by another nurse in form of rooster. PCA1 would take over those non complicated case. 11. If patient claimed that he/she had no smart phone, he/she will be followed by traditional method.
Result & Outcome :
1. Social message software is a widely-used messaging platform that is available on smartphones, making it easily accessible to a large number of patients. It increases accessibility and multimedia capabilities. Also, utilizing Social message software for follow-up can potentially reduce costs and time associated with traditional phone calls. The average time for nurses or PCA 1 spend on 1 case is about 1min. 2. Results retrieved from June 2023 to October 2023, we have follow up over 400 cases via Social message software, and received hundreds of appreciations from both patients and nurses. 3. Overall, the patient reply rate is 75%, and the patient compliance rate is over 80%.
