COPD patients could reduce their risk of exacerbations and learn self-management strategies for their condition by having regular telehealth consults with their GP
COPD patients could reduce their risk of exacerbations and learn self-management strategies for their condition by having regular telehealth consults with their GP, a panel of clinicians say.
GPs attending the virtual Air Time conference earlier this month were encouraged to use the new resources developed by the Lung Foundation of Australia to guide online or telephone consults with COPD patients.
Dr Kerry Hancock, GP and Chair of the RACGP’s Respiratory Medicine Specific Interests network, presenting at the conference, said preventing COPD exacerbations was vital not only for reducing patient mortality, but also reducing these patients risk of hospitalisation.
“We know that half of all patients who are admitted to hospital for an exacerbation won’t be alive in five years’ time,” she said.
And for patients who survive exacerbations, many will never fully recover, and most will have an increased risk of cardiovascular events, such as myocardial infarction and atrial fibrillation following an event.
Preventing exacerbations in COPD patients also reduced the financial burden these patients presented to the healthcare system, including their high risk of re-hospitalisation, Dr Hancock said.
But to prevent exacerbations, GPs have to employ a persistent evidence-based approach.
“Using telehealth since March, GPs are able to use checklists to remind ourselves, and our patients, of the aspects of care we should be focusing on during the consult,” Dr Hancock said.
One helpful resource is the Lung Foundation Australia My COPD Checklist, which GPs could have patients complete prior to the consult.
The resource covers any gaps in knowledge the patient may have about their condition and simultaneously flags the patient’s smoking habits and level of physical activity.
“We can assist our patients in helping to quit smoking, and no matter how hard it is, we should persist with it,” Dr Hancock said.
Another key part of a COPD consult was to encourage patients to remain physically active every day, or for at least 30 minutes a day five times a week.
Dr Hancock said encouraging exercise could prove more difficult in patients who would benefit from being referred to pulmonary rehab which has become inaccessible due to COVID-19 restrictions.
“We can refer them to rehab when it becomes available again, but in the meantime we should remind them to remain physically active,” Dr Hancock said.
Patients could be directed to the online COPD home exercise guide which was created to keep people active while indoors.
“It’s also a good time to make sure their influenza and pneumococcal vaccine is up to date, remembering that as of July 1, we’ll be doing Prevenar 13 for their first vaccination, instead of Pneumovax 24,” Dr Hancock said.
And helping patients recognise the signs of an exacerbation was also considered vital for ensuring they received prompt treatment and reduced the risk of hospitalisation.“I find often patients don’t know what they had, and what they got treated for was an exacerbation,” Dr Hancock said.
“We should let them know that all respiratory symptoms, such as increased breathlessness, a change in cough, or excess sputum needs early intervention, and that a delay, even of 24 hours, could double their risk of hospitalisation,” she said.
The resources for COPD self-management can be found at: https://lungfoundation.com.au/resources/
