Effectiveness of Western Medicine Outpatient Consultations in Primary Care

Background: Primary care plays an important role in health care delivery, but there is little research on its effectiveness. Western medicine is the most widely used and Traditional Chinese medicine (TCM) is gaining popularity. The investigators recent study showed that TCM consultations at the TWH were effective in improving the quality of life of patients in primary care. The aim of the present study is to evaluate the effectiveness of Western Medicine (WM) in primary care for comparison with the effectiveness of TCM consultations, so that policy makers and the public can be better informed. Objectives: To evaluate whether WM consultation can significantly improve the quality of life of patients in primary care and to find out whether there is any difference in the effectiveness of WM and TCM, overall and for different health problems. Design, Setting \& Subjects: A prospective study on 700 patients recruited from the TWH and the Ap Lei Chau primary care outpatient clinics (OPC) in Hong Kong. Methods: All patients consulting for a new episode of illness at the study OPC will be recruited if they meet the selection criteria and consent to participate. Each patient will be asked to complete a structured questionnaire on socio-demography, morbidity and service utilization, the Hong Kong version of the Chinese Quality of Life instrument (ChQOL-HK), the Chinese (Hong Kong) SF-36 (SF-36-HK) and the PEI-2 before the consultation. Each subject will be followed up two weeks later either at the clinic or by telephone to complete the ChQOL-HK and the SF-36-HK again together with the Patient Enablement Instrument (PEI), the Global Rating Scale (GRS) on change of the condition, and a questionnaire on service utilization Outcome Measures and Data Analysis: The primary outcome measures are the changes in ChQOL-HK and SF-36-HK scores after the consultation. The GRS and PEI scores will be secondary outcomes. The ChQOL -HK and SF-36-HK scores will be correlated with the the GRS and PEI. Multivariate regressions will be carried out to identify factors that are associated with effectiveness. The outcomes will be compared with those obtained from the previous study on the TCM primary care clinics. Results: This is the first study in Hong Kong to evaluate the effectiveness of WM in primary care with a validated generic outcome measure, HRQOL. It will provide information on the benefit and limitations of WM, and allow a direct comparison between WM and TCM.