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No ‘Lockdown’ on Chronic Disease Management

Rahul was diagnosed with hypertension. When the news of COVID-19 broke and public health officials stated that people with underlying issues were at higher risk, he panicked. National and international data suggest that people with chronic conditions such as hypertension and diabetes are at a higher risk of severe complications and poor outcomes, if they are infected with COVID-19.

 

Like Rahul, every fifth person in India suffers from chronic conditions. They find themselves in a tricky situation. On one hand, the lockdown has made it difficult for them to connect with their doctors. On the other hand, the change in Lifestyle, routine stress, and anxiety of the global crisis are further aggravating symptoms.

 

Chronic conditions need continuous care, especially now

In the conventional health system, a patient will attend a 10-minute consultation once every couple of months, give an overview of their health and mention any new symptoms or discomfort and  the doctor titrates the medications. Both patient and doctor are able to see only a part of the whole picture in this case. What happens between consultations is usually a gap of information that could be relevant to the treatment plan.

Take the example of Rahul, 34, who is busy climbing to the top of the corporate ladder. He was diagnosed with hypertension and saw a spike in cholesterol levels but that didn’t slow him down. He works hard, for long hours and gives equal importance to networking sessions which usually includes frequent wine and dine sessions with clients.


When his doctor pointed out the implication of his behaviours on his condition, he nodded. Rahul wants to change his behaviours, to eat clean, exercise regularly and manage stress. But there is simply no time.

Since the lockdown was initiated, his working hours have only grown longer. He finds himself spending most of the day seated in front of his laptop, and stress runs high because of the economic repercussions on his company. His own health seems to constantly be slipping lower on his priority list. Since he isn’t monitoring his blood pressure and LDLs regularly, he isn’t aware of just how badly his health is being affected.

Rahul is justifiably worried.

 

A complementary action plan

Patients with chronic conditions like diabetes stand to gain the most from healthcare models that offer continuous care. A better view of daily dietary patterns, activity, medication routine, and blood sugars can provide a holistic picture that will lead to better clinical decision making.

Doctors say individuals with chronic conditions must follow a complementary action plan to break this vicious loop especially during lockdown - prevent the risk of infection, and stabilise the underlying condition.

 

With stringent rules, the lockdown in itself is a measure to cut down the risk of infection by reducing contact with others with the condition.

 

To stabilise the patients must pay heed to their doctor’s advice and adapt healthy behaviours even while at home. This improves immunity, reduces fluctuations and prevents development of complications. And one effective way to ensure this is through remote monitoring and self-care.

 

The value of remote patient care

Remote patient monitoring (RPM) systems enable the monitoring of patients in the home or in a remote area that is outside the conventional clinical settings. And care is often delivered digitally, which will especially remain relevant in the current pandemic.

 

RPM has 4 important components; data collection devices or sensors to measure vitals or patient entered data, technology to share the collected data with doctors, a diagnostic software that develops intervention alerts based on the analysis of the collected data, and an advice relay system that carries recommendations from the doctor in response to the alert.

 

Newer systems are often programmed to empower patients to look after themselves, and together with timely interventions from their physicians, work towards a healthier population.

 

RPM can increase access to care and significantly reduce healthcare delivery costs. It can improve patients’ quality of life and help them maintain their independence, as they effectively manage their condition and reduce the risk of complications.

 

So, what’s next for patients like Rahul?

Through the new RPM systems, Rahul is an active participant who plays a proactive role in his treatment plan being a success.He can feed in information about his blood pressure, blood sugar, water consumption, meals, weight and activity to see firsthand how his blood pressure responds to dietary choices, medication habits and physical activity. 

 

He can also get access to an entire therapy built on clinical guidelines and behaviour science to get structured, easy and continuous care. He can learn about hypertension and the effects of his actions on his body and know how to effectively manage his condition and improve his health.

 

Simultaneously, Rahul’s doctor can monitor his performance from his computer to recognise and intervene in his healthcare management in a timely manner. The entire health system from caregivers, medication, medical device, and application can work synchronously to influence better health outcomes.

 

Conclusion

When it comes to digital transformation, the healthcare industry has been lagging behind. While digital technologies and Artificial Intelligence tools that make treatment smarter have been flourishing in pockets, mass adoption has been slow.

 

The lockdown is an opportunity to change that. As health systems turn to digital tools to overcome the limitations of the lockdown, the improved patient experience has been a welcome benefit.


Rahul can be worry free. Remote patient care is here to stay.  

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Dr. Sid Kolwankar

Guest Author AVP - Clinical and Product, Wellthy Therapeutics

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