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LCQ7: Elderly persons receiving specialist outpatient services
     Following is a question by Dr the Hon Helena Wong and a written reply by the Secretary for Food and Health, Professor Sophia Chan, in the Legislative Council today (June 19):
     In 2015, around 75 per cent of the elderly persons (i.e. persons aged 65 or above) in Hong Kong suffered from chronic illness. Some patient groups have pointed out that elderly patients with a number of chronic illnesses at the same time have to make a lot of efforts attending specialist outpatient clinics (SOPCs) in various public hospitals on different dates for treatment. Besides, they may not have the ability to sort out the medications prescribed by different doctors in order to take the medications according to schedule. In this connection, will the Government inform this Council:
(1) whether it knows in the past 12 months,
(i) the median and maximum numbers of SOPCs attended by the various elderly patients;
(ii) the number of elderly patients attending SOPCs for treatment, with a breakdown by the number of SOPCs attended by them (i.e. one to two, three to four, five to six, and seven or more) and the relevant percentages;
(iii) the median and maximum numbers of public hospitals visited by the various elderly patients for attending SOPCs for treatment; and
(iv) a breakdown of the number of elderly patients attending SOPCs for treatment by the number of public hospitals visited by them (i.e. one to two, three to four, five to six, and seven or more), and the relevant percentages;
(2) whether it knows, in each of the past three years, (i) for how many days on average were medications prescribed for each elderly patient by SOPCs, and (ii) the number of elderly patients who were prescribed five or more medications and the percentage of that number in the total number of such patients;
(3) given that under the Drug Refill Services E-Fill pilot programme launched by the Hospital Authority (HA), patients' prescriptions are split into smaller and manageable quantities, and pharmacists will review and reaffirm the latest condition of the patients before each refill, whether the Government knows the current number of patients covered by the pilot programme; and
(4) given that while elderly patients who suffer from a number of chronic illnesses have to attend a number of SOPCs for treatment and take a number of medications, they may not have adequate care support and the ability to manage the medications, whether it knows if HA will consider providing health management services for such patients under a case approach; if HA will, of the details; if not, the reasons for that?
     My reply to the various parts of the question raised by Dr the Hon Helena Wong is as follows:
(1) In 2018-19, the number of patients aged 65 or above who attended specialist outpatient clinics (SOPCs) of the Hospital Authority (HA) was about 687 000 (provisional figure), about 80 per cent of them received treatment by one to two specialties.  The HA does not maintain statistics on the median and maximum number of specialties attended by each elderly patient and the number of public hospitals each elderly patient has visited for specialist treatment.
(2) In each of the years between 2016 and 2018, the average prescription duration for HA patients aged 65 or above attending SOPCs with prescribed medications is around 94, 96 and 98 days respectively.  The numbers of prescriptions involving five or more items were around 870 000, 900 000 and 940 000 in the past three years, accounting for about 40 per cent of the total number of prescriptions for the above-said patients in each year respectively.
(3) Since December 2017, the HA has implemented the Drug Refill Services "E-Fill" pilot programme in phases at the Prince of Wales Hospital, the Tuen Mun Hospital and the Pamela Youde Nethersole Eastern Hospital.  Currently, the pilot programme covers about 25 000 Medical SOPC patients aged 60 or above who are typically prescribed with relatively more drug items.  The HA will review and refine the scope and operation workflow of the programme in a timely manner and extend its coverage to other hospitals progressively in order to benefit more patients.
(4) At present, medication review clinics are set up in a number of public hospitals where clinical pharmacists provide individual patients in need and their care-givers with medication consultation, counselling and related drug education as needed so as to enhance patient compliance in use of drugs.
Ends/Wednesday, June 19, 2019
Issued at HKT 12:35
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