Caring for chronic diseases in the pandemic
Chronic disease management and treatment adherence are taking a pretty serious hit as of late, and that is largely thanks to the spread of the novel coronavirus.
Many patients are afraid to visit their doctor’s office or the hospital for fear of exposing themselves to the virus.
This is especially problematic for patients with chronic illness, who need ongoing disease management in order to prevent the need for ER visits or hospitalisations.
Emergency room visits are costly for patient, payer and provider and can be exceptionally disruptive to patients’ lives.
Strong patient engagement in the community care setting has long been the bedrock of chronic disease management, with frequent check-ins with primary care providers and specialists being a key component of that care.
Amid the stress and confusion of coronavirus shutdowns and social-distancing orders, it can seem to patients as though everything is on pause.
Clinics have postponed regular office visits.
Patients worry about going to pharmacies and grocery stores.
One important fact must not get overlooked amid this pandemic: chronic health conditions still need attention.
If you had diabetes before the pandemic, you still have diabetes and should be monitoring your blood sugar levels.
If you were advised to follow a low-salt diet before the pandemic to control your blood pressure, you still need to follow a low-salt diet.
Exercise is still important during a pandemic.
High blood pressure, congestive heart failure or diabetes can also increase the risk of developing severe symptoms from Covid-19.
In the US Centre for Disease Control and Prevention sample, 73 per cent of older patients hospitalised with Covid-19 also had hypertension, about a third had diabetes and just over half had cardiovascular disease.
Therefore controlling these conditions is paramount.
How to keep seeing your doctor
Managing chronic conditions amid a pandemic is not easy. It requires adjusting daily routines and dealing with new obstacles.
One of the challenges is medical appointments.
Due to the pandemic, most clinics have postponed in-person visits for routine check-ups to avoid exposing patients or staff to the coronavirus. But that doesn’t mean your doctor isn’t there for you. Community physicians in Bermuda have transitioned most patient appointments to telemedicine.
This allows us to keep in touch with our patients and their symptoms and to adjust treatment plans in real time.
With new advances in technology, there are now multiple options for “virtual” visits between patient and doctor.
There are a number on online videoing platforms.
For patients who don’t have access to the internet or aren’t as comfortable with the technology, the telephone works too. Patients can send photos of injuries. Most clinic visits with my patients are now by telephone.
We schedule time for the clinic appointment, the clinic staff registers the patient and then we call the patient for the checkup.
The take away from all this is even if you don’t get Covid-19 it is still critically important that you continue to manage your chronic medical conditions.
When chronic conditions aren’t managed, patients run a higher risk of ending up in the emergency room and hospital — places where Covid-19 patients are likely also being treated and that have become overburdened amid the pandemic.
I would like to assure Bermuda during these uncertain times that your physicians are here for you. If you have a chronic disease, you need regular follow up with your GP.
If you have a medical concern, need refills, or just have questions, call your doctor’s office. Stay connected. Stay healthy. Stay safe.
• The Bermuda Medical Doctors Association is a body of more than 75 community physicians working directly for the welfare of the doctor/patient relationship
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