scholarly journals Predictors of switching from beta-blockers to other anti-hypertensive drugs: a review of records of 19,177 Chinese patients seen in public primary care clinics in the New Territory East, Hong Kong

2011 ◽  
Vol 10 (1) ◽  
pp. 10 ◽  
Author(s):  
Martin CS Wong ◽  
Harry HX Wang ◽  
Johnny Y Jiang ◽  
Stephen Leeder ◽  
Sian M Griffiths
Keyword(s):  
Primary Care ◽  
Hong Kong ◽  
Beta Blockers ◽  
Chinese Patients ◽  
Primary Care Clinics

scholarly journals Chronic Obstructive Pulmonary Disease (COPD) management in the community: how could primary care team contribute?

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
X. R. Catherine Chen ◽  
S. H. Leung ◽  
Y. C. Li
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Primary Care ◽  
Hong Kong ◽  
Phase 1 ◽  
Chronic Obstructive ◽  
Phase 2 ◽  
Obstructive Pulmonary Disease ◽  
Implementation Phase ◽  
Primary Care Clinics ◽  
Improvement Strategies

Abstract Background Chronic obstructive pulmonary disease (COPD) is a progressive lung disease commonly encountered in primary care. This study aimed to audit COPD care at primary care clinics of Hong Kong and to work out improvement strategies. Method All COPD patients aged 40 or above who had been followed up at 13 public primary care clinics of Kowloon Central Cluster (KCC) under the Hospital Authority of Hong Kong (HAHK) were included in this clinic audit. Evidence-based audit criteria and performance standards were established after thorough literature review. Phase 1 was from 1st April 2016 to 31st March 2017, with deficiencies of care identified. It was followed by a one-year implementation phase through which a series of improvement strategies were executed. Outcome of the enhancement was reviewed during Phase 2 from 1st April 2018 to 31st March 2019. Chi-square test and student’s t test were used to detect statistically significant changes between Phase 1 and Phase 2. Results A total of 2358 COPD cases were identified in Phase 1 where 658 of them were smokers. Of those smokers, 332 (50.5%) had been referred to Smoking Counselling and Cessation Service (SCCS) and 289 (43.9%) actually attended it. 991 cases (42%) received Seasonal Influenza Vaccine (SIV) and 938 cases (39.8%) received Pneumococcal Vaccine (PCV). 698 patients (29.6%) had spirometry done before and 423 patients (17.9%) had been admitted to hospital due to acute exacerbation of COPD (AECOPD). With the concerted effort taken during the implementation phase, Phase 2 data showed significant improvement in nearly all criteria. There was a marked increase in the SIV and PCV uptake rate, spirometry performance rate and most importantly, a significant reduction in AECOPD rate leading to hospital admission (13.5%, P = 0.000043). However, the referral rate and attendance rate of SCCS among smokers remained stagnant (P > 0.05). Conclusion Via a systematic team approach, COPD care at primary care clinics of KCC under HAHK had been significantly improved for most of the audit criteria, which in turn reduced the burden of the healthcare system.

scholarly journals A pilot study on the validity and psychometric properties of the electronic EQ-5D-5L in routine clinical practice

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Cindy Lo Kuen Lam ◽  
Emily Tsui Yee Tse ◽  
Carlos King Ho Wong ◽  
Joyce Sau Mei Lam ◽  
Sikky Shiqi Chen ◽  
...  
Keyword(s):  
Primary Care ◽  
Hong Kong ◽  
Clinical Practice ◽  
Psychometric Properties ◽  
Electronic Version ◽  
Routine Clinical Practice ◽  
Chinese Patients ◽  
Global Rating ◽  
Vas Scores ◽  
Eq Vas

Abstract Background Electronic measurement of health-related quality of life (HRQOL) may facilitate timely and regular assessments in routine clinical practice. This study evaluated the validity and psychometric properties of an electronic version of the EQ-5D-5L (e-EQ-5D-5L) in Chinese patients with chronic knee and/or back problems. Methods 151 Chinese subjects completed an electronic version of the Chinese (Hong Kong) EQ-5D-5L when they attended a primary care or orthopedics specialist out-patient clinic in Hong Kong. They also completed the Chinese Western Ontario and McMaster University Osteoarthritis Index (WOMAC), a Pain Rating Scale, and a structured questionnaire on socio-demographics, co-morbidities and health service utilization. 32 subjects repeated the e-EQ-5D-5L two weeks after the baseline. 102 subjects completed e-EQ-5D-5L and 99 completed the Global Rating on Change Scale at three-month clinic follow up. Construct validity was assessed by the association of EQ-5D-5L scores with external criterion of WOMAC scores. We tested mean differences of WOMAC scores between adjacent response levels of the EQ-5D-5L dimensions by one-way ANOVA, test–retest reliability by intra-class correlation, sensitivity by known group comparisons and responsiveness by changes in EQ-5D-5L scores over 3 months. Results There was an association between EQ-5D-5L and WOMAC scores. Mean WOMAC scores increased with the increase in adjacent response levels of EQ-5D-5L dimensions. Test–retest intraclass correlation coefficient (ICC) of EQ-5D-5L utility and EQ-VAS scores were 0.76 and 0.83, respectively, indicating good reliability. There were significant differences in the proportions reporting limitations in the EQ-5D-5L dimensions, the utility and VAS scores between the mild and severe pain groups (utility = 0.28, p = 0.001; VAS = 11.46, p < 0.001), and between primary care and specialist out-patient clinic patients (utility = 0.15, p = 0.001; VAS = 10.21, p < 0.001), supporting sensitivity. Among those reporting ‘better’ global health at three-months, their EQ-5D-5L utility and EQ-VAS scores were significantly increased from baseline (utility = 0.18, p < 0.001; VAS = 10.75, p = 0.005). Conclusions The electronic version of the EQ-5D-5L is valid, reliable, sensitive and responsive in the measurement of HRQOL in Chinese patients with chronic knee or back pain in routine clinical practice.

scholarly journals Chronic Obstructive Pulmonary Disease (COPD) management in the community: how could primary care team contribute?

2020 ◽  
Author(s):  
Catherine Xiao Rui CHEN ◽  
Siu Hong Leung ◽  
Yim Chu Li
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Primary Care ◽  
Hong Kong ◽  
Phase 1 ◽  
Chronic Obstructive ◽  
Phase 2 ◽  
Obstructive Pulmonary Disease ◽  
Implementation Phase ◽  
Primary Care Clinics ◽  
Improvement Strategies

Abstract Background: Chronic obstructive pulmonary disease (COPD) is a progressive lung disease commonly encountered in the primary care. This study aimed to audit COPD care at primary care clinics of Hong Kong and to work out improvement strategies. Method: All COPD patients aged 40 or above and had been followed up at 13 public primary care clinics of Kowloon Central Cluster (KCC), the Hospital Authority of Hong Kong, were included in this clinic audit. Evidence-based audit criteria and performance standards were established after thorough literature review. Phase 1 was from 01/04/2016 to 31/03/2017, with deficiencies identified, followed by one-year implementation phase with improvement strategies being executed. Phase 2 was from 01/04/2018 to 31/03/2019 with outcome of enhancement reviewed. Chi-square test and student’s t test were used to compare the significance of relevant changes noted. Results: 2,358 COPD cases were identified in phase 1. Among the 658 smokers, 332 (50.5%) had been referred to Smoking Counselling and Cessation and Service (SCCS) and 289 (43.9%) actually attended it. 991 cases (42%) received Seasonal Influenza Vaccine (SIV) and 938 (39.8%) received Pneumococcal Vaccine (PCV). 698 (29.6%) patients had spirometry done before and 423 cases (17.9%) had been admitted to hospital due to acute exacerbation of COPD (AECOPD). With the concerted effort taken during the implementation phase, phase 2 data showed significance improvement in almost all criteria. There was a marked improvement in SIV and PCV coverage, spirometry performance rate and most important of all, a reduction in the AECOPD (n=294, 13.5%, P=0.000043). However, the SCCS referral rate and attendance rate among smokers remained stagnant (both P>0.05). Conclusion: COPD care at primary care clinics of KCC has been tremendously improved in most of the audit criteria via a systematic team approach, therefore reducing the burden to specialist and hospital.

scholarly journals Quality of diabetes care in public primary care clinics in Hong Kong

2011 ◽  
Vol 29 (2) ◽  
pp. 196-202 ◽  
Author(s):  
K. W. Wong ◽  
S. Y. Ho ◽  
D. V. K. Chao
Keyword(s):  
Primary Care ◽  
Hong Kong ◽  
Diabetes Care ◽  
Primary Care Clinics ◽  
Quality Of Diabetes Care

scholarly journals Chronic Obstructive Pulmonary Disease (COPD) management in the community: how could primary care team contribute?

2020 ◽  
Author(s):  
Catherine Xiao Rui CHEN ◽  
Siu Hong Leung ◽  
Yim Chu Li
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Primary Care ◽  
Hong Kong ◽  
Phase 1 ◽  
Chronic Obstructive ◽  
Phase 2 ◽  
Obstructive Pulmonary Disease ◽  
Implementation Phase ◽  
Primary Care Clinics ◽  
Improvement Strategies

Abstract Background: Chronic obstructive pulmonary disease (COPD) is a progressive lung disease commonly encountered in primary care. This study aimed to audit COPD care at primary care clinics of Hong Kong and to work out improvement strategies. Method: All COPD patients aged 40 or above who had been followed up at 13 public primary care clinics of Kowloon Central Cluster (KCC) under the Hospital Authority of Hong Kong (HAHK) were included in this clinic audit. Evidence-based audit criteria and performance standards were established after thorough literature review. Phase 1 was from 1st April 2016 to 31st March 2017, with deficiencies of care identified. It was followed by a one-year implementation phase through which a series of improvement strategies were executed. Outcome of the enhancement was reviewed during Phase 2 from 1st April 2018 to 31st March 2019. Chi-square test and student’s t test were used to detect statistically significant changes between Phase 1 and Phase 2. Results: A total of 2,358 COPD cases were identified in Phase 1 where 658 of them were smokers. Of those smokers, 332 (50.5%) had been referred to Smoking Counselling and Cessation Service (SCCS) and 289 (43.9%) actually attended it. 991 cases (42%) received Seasonal Influenza Vaccine (SIV) and 938 cases (39.8%) received Pneumococcal Vaccine (PCV). 698 patients (29.6%) had spirometry done before and 423 patients (17.9%) had been admitted to hospital due to acute exacerbation of COPD (AECOPD). With the concerted effort taken during the implementation phase, Phase 2 data showed significant improvement in nearly all criteria. There was a marked increase in the SIV and PCV uptake rate, spirometry performance rate and most importantly, a significant reduction in AECOPD rate leading to hospital admission (13.5%, P=0.000043). However, the referral rate and attendance rate of SCCS among smokers remained stagnant (P>0.05). Conclusion: Via a systematic team approach, COPD care at primary care clinics of KCC under HAHK had been significantly improved for most of the audit criteria, which in turn reduced the burden of the healthcare system.

scholarly journals Ten-year risk prediction models of complications and mortality of Chinese patients with diabetes mellitus in primary care in Hong Kong: a study protocol

BMJ Open ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. e023070 ◽  
Author(s):  
Eric Yuk Fai Wan ◽  
Esther Yee Tak Yu ◽  
Weng Yee Chin ◽  
Colman Siu Cheung Fung ◽  
Ruby Lai Ping Kwok ◽  
...  
Keyword(s):  
Primary Care ◽  
Hong Kong ◽  
Risk Prediction ◽  
Prediction Models ◽  
Cost Effective ◽  
Chinese Patients ◽  
Risk Prediction Models ◽  
Hospital Authority ◽  
All Cause Mortality ◽  
Patients With Diabetes

IntroductionDiabetes mellitus (DM) is a major disease burden worldwide because it is associated with disabling and lethal complications. DM complication risk assessment and stratification is key to cost-effective management and tertiary prevention for patients with diabetes in primary care. Existing risk prediction functions were found to be inaccurate in Chinese patients with diabetes in primary care. This study aims to develop 10-year risk prediction models for total cardiovascular diseases (CVD) and all-cause mortality among Chinese patients with DM in primary care.Methods and analysisA 10-year cohort study on a population-based primary care cohort of Chinese patients with diabetes, who were receiving care in the Hospital Authority General Outpatient Clinic on or before 1 January 2008, were identified from the clinical management system database of the Hospital Authority. All patients with complete baseline risk factors will be included and followed from 1 January 2008 to 31 December 2017 for the development and validation of prediction models. The analyses will be carried out separately for men and women. Two-thirds of subjects will be randomly selected as the training sample for model development. Cox regressions will be used to develop 10-year risk prediction models of total CVD and all-cause mortality. The validity of models will be tested on the remaining one-third of subjects by Harrell’s C-statistics and calibration plot. Risk prediction models for diabetic complications specific to Chinese patients in primary care will enable accurate risk stratification, prioritisation of resources and more cost-effective interventions for patients with DM in primary care.Ethics and disseminationThe study was approved by the Institutional Review Board of the University of Hong Kong—the Hospital Authority Hong Kong West Cluster (reference number: UW 15–258).Trial registration numberNCT03299010; Pre-results.

scholarly journals Enhancing the triage and cohort of patients in public primary care clinics in response to the coronavirus disease 2019 (COVID-19) in Hong Kong: an experience from a hospital cluster

BJGP Open ◽  
2020 ◽  
Vol 4 (2) ◽  
pp. bjgpopen20X101073 ◽  
Author(s):  
Pang Fai Chan ◽  
Kit Ping Loretta Lai ◽  
David Vai Kiong Chao ◽  
Sau Chun Kitty Fung
Keyword(s):  
Primary Care ◽  
Hong Kong ◽  
Primary Care Clinics

scholarly journals Clinic audit on Chronic Obstructive Pulmonary Disease (COPD) management in public primary care setting: Hong Kong experience

2020 ◽  
Author(s):  
Chen Xiao Rui Catherine ◽  
Fu Sau Nga ◽  
Leung Wing Kit ◽  
Ng Sze Wing Catherine ◽  
Kwan Wing Yan Wendy ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Primary Care ◽  
Hong Kong ◽  
Hospital Admission ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Implementation Phase ◽  
Primary Care Clinics ◽  
Improvement Strategies

AbstractBackgroundChronic obstructive pulmonary disease (COPD) is a common condition encountered in primary care and presents a substantial burden to the health care system. This study aimed to audit COPD care at all public primary care clinics of Hong Kong and to work out improvement strategies.MethodThe computer record of COPD patients aged 40 or above and had been followed up at any of the 73 public primary care clinics under the Hospital Authority of Hong Kong (HAHK) were reviewed. Evidence-based audit criteria and performance standards were established after thorough literature review. In the first phase from 1st April 2017 to 31st March 2018, deficiencies of care were identified. It was followed by a one-year implementation phase through which a series of improvement strategies were executed. Outcome of the service enhancement was assessed in the second phase from 1st April 2019 to 31st March 2020. Student’s t test and Chi-square test were used to identify any statistically significant changes between the two.ResultsTotally 10,385 COPD cases were identified in Phase 1, among whom 3,102 (29.9%) were active smokers. Most of the patients were male (87.7%) and the mean age was 75.3±9.9 years old. Of those smokers, 1,788 (57.6%) had been referred to Smoking Counselling and Cessation Service (SCCS) and 1,578 (50.9%) actually attended it. 4,866 cases (46.9%) received Seasonal Influenza Vaccine (SIV) and 4,227 cases (40.7%) received Pneumococcal Vaccine (PCV). 1,983 patients (19.1%) had spirometry done before and 1,327 patients (12.8%) had been admitted to hospital due to acute exacerbation of COPD (AECOPD). With the concerted effort taken during the implementation phase, Phase 2 data showed a significant improvement in all criteria. There was a marked increase in the SIV and PCV uptake rate, spirometry performance rate and most importantly, a significant reduction in AECOPD rate leading to hospital admission (9.6%, P<0.00001).ConclusionCOPD care at all public primary care clinics of HAHK had been significantly improved for all audit criteria via the systematic team approach, which in turn reduced the hospital admission rate and helped relieve the burden of the healthcare system.

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