Inhaler Review in Older Adults with Asthma or COPD: A Cost‐Effectiveness Study and a Perspective in Portugal

Maricoto, Tiago; Marques‐Gomes, João; Sousa, Jaime Correia de; Taborda-Barata, Luís

doi:10.1111/jgs.15834

Cited by 10 publications

(12 citation statements)

References 40 publications

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“…In counselling, patients are always the expert when it comes to their own life, and counselling which takes into account the client's life situation will help achieve the treatment goals (Rajala et al 2018). The quality of asthma counselling has also been shown to reduce the cost of care (Haahtela et al 2017;Maricoto et al 2019) and amount of sick leave (Haahtela et al 2017).…”

Section: Introductionmentioning

confidence: 99%

Patient evaluations of asthma counselling quality in primary health care — a cross-sectional survey

Mäkelä¹,

Rajala

Kivelä³

et al. 2020

J Public Health (Berl.)

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Background Healthcare staff have a key role in counselling patients. This study describes asthma patients' evaluations of primary care counselling quality. Methods The research applied a cross-sectional study design, with data collected from adult asthma patients (n = 73). Data were analysed by descriptive statistics. Results Most of participating patients were women (73%) and over 60 years old (67%). The patients were generally satisfied with the counselling. Subjection to an asthma test (p = 0.009) and smoking (p = 0.019) were found to significantly positively affect patient perceptions of counselling quality. The patients also felt that support services should be covered more (74%). Patients with comprehensive education (p = 0.039) and smokers (p = 0.015) were more likely to be satisfied with the counselling than other patients. Counselling was client-oriented (53%) and most patients reported experiencing positive interactions (92%). Most patients agreed that counselling benefitted adherence to self-care (75%) and health promotion (67%). Moreover, almost all of the patients were satisfied with the staff members' knowledge and skills (97%). Subjection to an asthma test (p = 0.043), age (p = 0.030), smoking (p = 0.014), and duration of illness (p = 0.002) influenced satisfaction with counselling resources. Conclusion The results indicate that counselling benefits asthma patients. Performing an asthma test, as well as considering smoking habits and educational level, can improve patient perceptions of counselling.

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Section: Introductionmentioning

confidence: 99%

Patient evaluations of asthma counselling quality in primary health care — a cross-sectional survey

Mäkelä¹,

Rajala

Kivelä³

et al. 2020

J Public Health (Berl.)

View full text Add to dashboard Cite

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“…In addition, some process indicators such as assessment on inhaler technique and drug adherence had not been included. This gap will need to be lled as evidence has revealed that inhaler technique education signi cantly reduced exacerbation rate (24), and is shown to be more cost-effective (25). Subsequent studies focusing on the long-term outcome criteria and inhaler technique may help provide a more comprehensive picture of COPD management.…”

Section: Discussionmentioning

confidence: 99%

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

CHEN

Leung

2020

Preprint

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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.

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“…In addition, some process indicators such as assessment on inhaler technique and drug adherence had not been included. This gap needs to be lled in future studies as evidence has shown that inhaler technique education signi cantly reduces the exacerbation rates (24) and is more cost-effective (25). Subsequent studies focusing on the long-term outcome criteria and inhaler technique may help provide a better guide for COPD assessment.…”

Section: Discussionmentioning

confidence: 99%

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

CHEN

Leung

2020

Preprint

View full text Add to dashboard Cite

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.

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Inhaler Review in Older Adults with Asthma or COPD: A Cost‐Effectiveness Study and a Perspective in Portugal

Cited by 10 publications

References 40 publications

Patient evaluations of asthma counselling quality in primary health care — a cross-sectional survey

Patient evaluations of asthma counselling quality in primary health care — a cross-sectional survey

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

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

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