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Non-communicable disease management in vulnerable patients during Covid-19
1Senior Resident, Department of Community Medicine, Maulana Azad Medical College, 2, Bahadur Shah Zafar Marg, New Delhi 110 002 INDIA.
Insights
Non-communicable diseases (NCDs) increase COVID-19 severity, yet healthcare disruptions risk NCD patient care. Innovative strategies like extended refills and telemedicine are crucial for managing NCDs during epidemics.
Area of Science:
- Public Health
- Epidemiology
- Health Policy
Background:
- Non-communicable diseases (NCDs) like diabetes and hypertension heighten COVID-19 susceptibility and mortality, especially in the elderly.
- COVID-19 control measures have inadvertently disrupted essential healthcare services for millions of NCD patients.
- Inadequate primary healthcare infrastructure and non-adherence to physical distancing exacerbate risks for vulnerable populations.
Purpose of the Study:
- To examine the impact of COVID-19 on NCD patient care in India.
- To identify challenges in managing NCDs during public health emergencies.
- To explore feasible interventions for ensuring continuity of care for NCD patients.
Main Methods:
- Review of healthcare management strategies during the COVID-19 pandemic.
- Analysis of the impact of facility closures and infrastructure limitations on NCD patients.
- Exploration of potential solutions including telemedicine and drug delivery systems.
Main Results:
- Disruption of outpatient facilities led to medication and diagnostic gaps for NCD patients.
- Socioeconomic vulnerability and poor infrastructure increase the risk of non-adherence and complications.
- Existing healthcare systems face challenges in maintaining essential services during epidemics.
Conclusions:
- Urgent exploration of strategies like extended drug refills, home delivery, dedicated NCD clinics, and telemedicine is necessary.
- Proactive public health interventions are vital to mitigate risks for NCD patients during pandemics.
- Addressing the dual burden of NCDs and infectious diseases requires integrated and resilient healthcare approaches.
Abstract:
It is now well established that non-communicable diseases (NCD), like diabetes mellitus, hypertension,, respiratory and heart disease, particularly among the elderly, increase the susceptibility to COVID-19 disease. Mortality in 60%-90% of the COVID-19 cases is attributed to either one or more of these comorbidities. However, healthcare management for control of COVID-19 involves public health and policy decisions that may critically undermine the existing health needs of the most vulnerable NCD patients. Temporary closure of outpatient health facilities in some secondary and tertiary care hospitals have deprived millions of NCD patients of their regular medication and diagnostic health needs. The lack of robust primary healthcare facilities in most states, and the failure to maintain physical distancing norms due to inadequate infrastructure is also problematic. In the absence of effective public health interventions, socioeconomically vulnerable patients are likely to become non-adherent increasing manifold their risk of disease complications. In this context, the feasibility of dispensing longer than usual drug refills for chronic NCD conditions at functional government health facilities, home delivery of essential drugs, running dedicated NCD clinics at PHCs, and utilisation of telemedicine opportunities for care and support to patients warrant aggressive exploration. Keywords: Covid-19, NCDs, Medical ethics, epidemic, India.
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