Authors (including presenting author) :
Chan WH, Leung SY, Yeung NK, Au KM
Affiliation :
Extended Care Unit, Lai King Building, Princess Margaret Hospital
Keyword 1: :
Chronic obstructive pulmonary disease
Keyword 2: :
Patient empowerment
Keyword 3: :
Self-management
Keyword 4: :
Inhalation device technique
Keyword 6: :
Hospital readmission
Introduction :
Pulmonary rehabilitation has been shown to improve exercise capacity, alleviate symptoms, enhance quality of life, and reduce hospital admissions among COPD patients. Between 2022 and 2023, annual hospital admissions for COPD rose sharply from 10,450 to 16,539, which highlighting a pressing need for enhanced management strategies. The COPD Rehabilitation Program has been implemented at LKB since 2017. To address the growing burden and increase service coverage for suitable patients, the program was enhanced in May 2025
Objectives :
1.Enhance patient adherence to prescribed medications. 2.Shorten hospital stays for COPD patients. 3.Decrease COPD-related hospital readmission rates
Methodology :
Since 2017, applying a multidisciplinary approach, trained nurses screen all transferred COPD cases at LKB based on established selection criteria. Comprehensive assessments—including history taking, inhalation device technique evaluation, and spirometry—are conducted, followed by tailored education and training for eligible patients. In May 2025, the eligibility was expanded. The Modified Functional Ambulatory Category (MFAC) criterion was lowered from ≥6 to ≥4, enrolling more dependent patients into the program. Caregivers were actively involved in the patient pathway. Training on inhaler technique and self-management were provided to patients and caregivers. They are encouraged to install HA GO and use Tele-information via ward iPads or personal smartphones during hospitalization and after discharge. Those unwilling to use HA GO receive educational leaflets developed by HKRNC and HKTS, with QR codes linking to instructional videos. After completing the program, patients transition to community-based care under the follow-up of CNS.
Result & Outcome :
Following the enhancement, 37 patients were screened, and 22 enrolled between 14 May 2025 and 28 December 2025. Comparisons of pre- and post- intervention showed FEV1% increased by 1.37%. Technique accuracy for PMDI increased by 41%. SMI technique improved by 51%, while DPI technique increased by 50%. Patient satisfaction rate is 97% and the median length of stay is nine days. The 28-day unplanned readmission rate is 15%. To conclude, the result indicates that expanding eligibility and integrating structured education for patients and caregivers, supported by digital tools, can improve self-management skills and clinical metrics in COPD patients.
