February 16, 2016

Health professionals and community groups CHAT to help keep patients with COPD out of hospital

Lung Foundation Australia is considering a broader rollout of its ‘Have the CHAT’ campaign this year following a successful pilot that saw unprecedented collaboration between health professionals and community organisations.

The Lung Foundation, with sponsor AstraZeneca, worked together with Primary Health Networks (PHNs), hospitals, health professionals and community organisations in six regions across Australia to raise awareness of the symptoms of a COPD exacerbation.

More than 800 gGPs registered for the winter pilot campaign to ‘Have the CHAT’ with their patients to help them recognise the worsening symptoms of COPD which may help in avoiding hospital admissions.

All registered GPs received a free suite of tools which included an exacerbation algorithm, COPD Action Plan and COPD-X Concise Guide for Primary Care, as well as ‘Have the CHAT’ poster, flyer and patient video.

“The ‘Have the CHAT’ initiative worked well because it was a community effort. PHNs helped to promote the campaign to GPs, practice nurses and practice managers. Community organisations also got on board to help promote the campaign to patients, their carers and friends,” said Heather Allan, CEO of Lung Foundation Australia.

COPD is the second leading cause of preventable hospitalisation in Australia1. Each COPD exacerbation does long-term damage and patients admitted to hospital for an exacerbation are more likely to die in the following 12 months than those admitted with a heart attack2.

However, many patients don’t recognise the signs and symptoms of a COPD exacerbation early enough, which may result in them being admitted to hospital. The initiative communicated the ‘CHAT’ acronym to highlight the common symptoms:

Coughing more than usual

Harder to breathe than usual

Any change in sputum (phlegm) colour or volume, and

Tired more than usual.

“An awareness campaign like ‘Have the CHAT’ is critical in helping patients with COPD and their carers understand their symptoms and encouraged them to visit a GP to discuss strategies to manage COPD exacerbations early,” explains Dr. Kerry Hancock, Lung Foundation Australia’s General Practice Advisory Group Chair and member of the COPD National Program Executive.

“The campaign message about visiting your GP to develop a COPD action plan is extremely important for patients with COPD. A delay of 24 hours or more in initiation of treatment for an exacerbation, doubles the chance of hospital admission,”3 said Dr. Hancock.

GP feedback about the campaign has been primarily positive, with some suggesting that the initiative should be applied nationwide since COPD is common and widespread.  Most doctors also noted that they would likely recommend the initiative to colleagues and participate in the initiative again4.

A number of GPs also commented that the campaign materials were helpful, specifically the action plans and the algorithms that were useful to help patients manage worsening symptoms4.  One GP said, “The campaign made me think about offering spirometry to all ex-smokers as a result4.”

On top of the health impact, COPD costs around $8.8 billion each year due to loss in productivity as a result of lower employment, absenteeism or impact of premature death. COPD is $900 million burden on the Australian healthcare system, with hospital use contributing the largest share of health spending ($473million)5.

Given the health and economic burden of COPD, the PHNs and hospitals involved were very supportive of the initiative, especially since COPD was identified as a key health focus in their areas.

Sixty community organisations and groups including bowling clubs, RSLs, pharmacies and patient support groups in each area also agreed to display the posters and distribute flyers to raise awareness of this important health issue.

“It was a great idea to have the community organisations involved because that’s where the patients are,” said Krista Fischer, Primary Care Consultant, Western Victoria Primary Health Network.

The pilot was conducted in Sunshine Coast, Gold Coast, Grampians, Northern Adelaide, Northern Sydney and Tasmania.