Use of spirometry to motivate patient in smoking cessation in General Out Patient Clinics, Kowloon Central Cluster 2018

Abstract Description

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Authors (including presenting author) :

Lai P(1), Ha LM(1), Leung B(1), Leung SH(1), Choi CMC(1), Leung TF(1)

Affiliation :

(1) Department of Family Medicine and General Outpatient Clinics (GOPCs),
Kowloon Central Cluster (KCC)

Introduction :

Smoking cessation is important in primary health care service as smoking will increase the risk of developing chronic obstructive pulmonary disease (COPD) and cardiovascular diseases. Patients’ motivation in quitting smoking is the key to success. Since 2016, a handy simple spirometry (COPD-6) was introduced to KCC GOPCs to provide a basic lung function assessment for smokers. This study aims to examine if this can help smokers to quit smoking.

Objectives :

Use of spirometry to motivate patient in smoking cessation in General Out Patient Clinics

Methodology :

In April 2016, the Smoking Cessation and Counselling Program (SCCP) of KCC GOPCs had been revisited with simple spirometry (COPD-6) introduced. The use of COPD-6 was firstly piloted at Lee Kee Memorial Dispensary and was then gradually implemented in all GOPCs in KCC. All smokers attended GOPC with COPD-6 equipped would receive COPD-6 assessment before they attended the SCCP for smoking cessation service. COPD-6 assessment was done by trained nurses. FEV1, FEV1/FEV6 were measured and smoker’s lung age would be calculated. These spirometry results would be explained by SCCP counsellors to allow smokers to better understand their health condition. Besides, doctors would be informed for further management if the findings suggestive of COPD. The quit rate of smokers received COPD-6 assessment versus those without during the period from Nov 2017 to Oct 2018 were compared using the chi-square test, and P<0.05 is considered as statistically significant.

Result & Outcome :

From Nov 2017 to Oct 2018, a total of 785 smokers were recruited to SCCP. Among these smokers, 281 patients were recruited at GOPCs without COPD-6 equipped while 504 patients were recruited at GOPCs with COPD-6 equipped.
For those smokers without COPD-6 assessment, quit rate at 6-month was 34% and 12-month quite rate 36.8%.
For patients with COPD-6 assessed, quit rate at 6 month and 12 month was higher with 54.7% (6-month) and 55.2% (12-month) comparatively (both P value<0.001). This retrospective study showed the introduction of simple spirometry in primary care setting can play a role in increasing patient self-awareness in own health status. It enhanced the patients’ motivation and facilitated the smoking cessation. In addition, the patient at higher risk of developing COPD would be arranged for further assessment for early diagnosis and treatment. Remarks: Quit rate: Base on contactable patient for the smoking status