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Register ‘key’ to tackling chronic diseases

Debbie Jones, Bermuda Diabetes Association chairwoman

A Chronic Disease Register is key to understanding and tackling Bermuda’s chronic non-communicable diseases, according to two health charities.

Bermuda Diabetes Association chairwoman Debbie Jones said it would shed light on the full extent of the problem while also raising awareness of such conditions.

“The fact that Government is now highlighting NCDs and diabetes as important is key,” Ms Jones told The Royal Gazette.

She said the real importance of the register is “we find out how many people have diabetes”, which she said had been difficult to establish previously.

According to Ms Jones, it will also help heighten awareness of type one and type two diabetes, while emphasising that keeping abreast of the disease is important.

The register will be developed by the Ministry of Health and Seniors “to monitor the prevalence of chronic diseases such as diabetes and kidney and heart disease”.

Monday’s Throne Speech noted that the register would identify baseline levels of diseases with high impact on the society and to put in place interventions and preventive measures.

But it would also require collaboration between public and private healthcare practitioners for reliable reporting.

Ms Jones said the register would also stress the importance of recording the conditions to physicians, who deal with a lot of different conditions daily.

“By virtue of creating a register, you’re asking physicians to record when they have a newly diagnosed patient.”

But she added that knowing the full extent of the problem would also make it easier to ask for more resources. “A register has been recognised as one of the most important things we can do,” she added.

Simone Barton, CEO of the Bermuda Heart Foundation, also welcomed the register, telling this newspaper that it was a “key component” to understanding and tackling the island’s health challenges.

“Knowledge is power. If we know what we are dealing with, then we are better able to handle it and place resources based on data and not assumptions.”

Ms Barton added that the register could be a wake-up call to the community and could help make people more proactive in managing their NCDs.

She also stressed that most of the diseases were preventable and that Bermuda must start looking towards prevention rather than a cure to cut healthcare costs.

The Throne Speech also announced the creation of the Patient-Centred Medical Home, which aims to help under or uninsured persons cope with their chronic NCDs [see sidebar below]. Other initiatives include the Long Term Care Action Plan and the Premier’s Council on Fitness, Sports and Nutrition, which was created to provide leadership, with a particular focus on children.

According to the Bermuda Health Council, the initiatives are “all steps in the right direction”.

CEO Tawanna Wedderburn said: “The Health Council wholeheartedly agrees with the Ministry of Health and Seniors that implementing strategies to provide access to quality healthcare is vitally important.

“The Chronic Disease Register, Long Term Care Action Plan, hospital-based medical home and the Premier’s Council on Fitness, Sports and Nutrition are all steps in the right direction to reduce costs, align with international practices, and increase transparency.

“And, more transparency will encourage active participation from residents, corresponding with the Health Council’s recently launched campaign of creating safer healthcare.”

<p>Helping the uninsured</p>

Monday’s Throne Speech revealed the setting up of a new hospital-based service to help tackle chronic non-communicable diseases.

The Patient-Centred Medical Home service, which is being established by Bermuda Hospitals Board, aims to help under or uninsured individuals manage their chronic diseases.

A BHB spokeswoman said: “This will be a referral service for individuals with chronic diseases, such as diabetes, who are not currently seeing a GP and who are under or uninsured.

“The goal is to work with these individuals and help them manage their chronic disease. This will help reduce hospitalisation and complications, such as amputation and dialysis, which impact quality of life and are costly to the healthcare system.

“We look forward to sharing more about the service as it is rolled out.”

The new initiative will stress the need to tackle chronic NCDs — the “biggest cause of death in Bermuda”. “Three in four adults are overweight or obese, which leads to long-term medical problems that not only debilitate the individual but also impose serious cost burdens on the health system,” noted the Throne Speech .

“Lower-income individuals who lack access to appropriate care are the most seriously affected. The situation often leads to revolving door hospitalisations and inappropriate use of emergency services. To manage the situation, the Bermuda Hospitals Board will establish a hospital-based ‘medical home’ programme to manage the needs of individuals with chronic, non-communicable diseases.”