Establishment of an Asthma & COPD clinic in a university primary care unit: Coordination between Primary and Tertiary care

The Asthma and COPD Clinic at Srinagarind Hospital, Khon Kaen University (KKU) in Thailand, launched in early 2023 with the objective of enhancing the management of respiratory diseases in the university's primary care unit. The project addressed challenges identified during the screening of new university students, revealing unnecessary referrals to the tertiary care center and issues with patient follow-up. A multidisciplinary team, comprising asthma specialists, family medicine doctors, nurses, pharmacists, and other health care providers, collaborated to develop a comprehensive service system. The goals were to improve access to primary care for respiratory patients, ensure continuity of care, and reduce acute exacerbations, emergency room visits, and hospital admissions. The development plan involved creating guidelines, surveying and screening university communities, publicizing the clinic online, and implementing the Asthma and COPD clinic. The clinic process included medical history-taking, physical examination, peak flow measurement, and collaborative decision-making among health care providers, following established clinical guidelines from Thai-PCRG. A follow-up system was established using an online platform to ensure patient engagement and care continuity. Results from the clinic's implementation demonstrated success, with all diagnosed asthma patients receiving primary care, showing no history of acute exacerbations, emergency room visits, or hospital admissions. No loss to follow-up has been observed. Key lessons emphasized the importance of a multidisciplinary team and supportive health policies. Limitations and opportunities highlighted the need for more proactive screening policies and potential service expansion to a broader range of university students and personnel. Future projects may prioritize increasing awareness about asthma care continuity in university settings. In summary, this Asthma and COPD Clinic has significantly improved respiratory disease management in the university's primary care unit through collaborative efforts and a comprehensive service system. The successful outcomes underscore the importance of a multidisciplinary approach and offer opportunities for further development and awareness initiatives.