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Home / India News / Managing non-Covid diseases in focus of latest ICMR review

Managing non-Covid diseases in focus of latest ICMR review

ICMR’s National Centre for Disease Informatics and Research (NCDIR), the centre working on the guidelines on managing NCDs, is using its many registries— cancer, stroke, cardiovascular disease etc.— to track patients, and identify and address gaps in disease management.

india Updated: Jun 01, 2020 04:25 IST
Rhythma Kaul
Rhythma Kaul
Hindustan Times, New Delhi
As per health ministry data, of the 165,799 total confirmed Covid-19 cases reported from India, at least 70% of the patients were suffering from some underlying medical condition such as hypertension, diabetes, kidney or liver disease.
As per health ministry data, of the 165,799 total confirmed Covid-19 cases reported from India, at least 70% of the patients were suffering from some underlying medical condition such as hypertension, diabetes, kidney or liver disease. (Yogendra Kumar/HT Photo)

How to adjust drug dose in cancer patients who are on chemotherapy or optimise dialysis benefits to avoid frequent hospital visits by patients with chronickidneyconditions is part of a large Indian Council of Medical Research (ICMR) review of management of non-communicable diseases (NCDs) in the times of coronavirus disease (Covid-19) restrictions and increased infection risk.

People with major NCDs run the risk of developing a severe form of Covid-19.

ICMR’s National Centre for Disease Informatics and Research (NCDIR), the centre working on the guidelines on managing NCDs, is using its many registries— cancer, stroke, cardiovascular disease etc.— to track patients, and identify and address gaps in disease management.

Hospitals will also be asked to link up with doctors in the periphery, who will be adequately trained, so that instead of a patient visiting a tertiary care hospital, he or she can have certain complications treated at smaller centres, and even make optimal use of telemedicine.

“Since the virus is here to stay, we will have to work around the restrictions in place due to Covid-19 situation and look for solutions keeping in mind several advisories that are in place. There are non-Covid patients, especially those with major NCDs involving heart, kidney, brain etc. who need regular care but run the risk of contracting infection if they are made to frequent hospitals, and are likely to develop severe form of illness because of their co-morbid conditions,” said Dr Prashant Mathur, director, NCDIR, who is working on the guidelines.

According to the Union health ministry data, of the 165,799 total confirmed Covid-19 cases reported from India, at least 70% of the patients were suffering from some underlying medical condition such as hypertension, diabetes, kidney or liver disease. Also, among 4,706 deaths that India has reported so far, at least 75% were suffering from at least one of these chronic conditions.

The guidelines will have three aspects to it: one will focus on how to manage patients with existing NCDs, another will be to guide doctors and other medical staff involved in treating these patients, and the third aspect is to launch minor studies on coping mechanism during Covid by patients as well as doctors.

“The main focus will be on how to ensure the number of visits to hospitals is reduced for this high risk category population. As for treating of most major NCDs, patients normally land up at tertiary care hospitals. The experts will be looking at how to adjust dosage of certain medicines such as in case of chemotherapy so that the side-effects are minimized. In chemo patients most hospital visits happen due to side effects of the drug; so lowering dosage might help patients tolerate it better and hospital visits will automatically reduce. In case of dialysis also we are trying to see how to optimize the benefits that could cut the number of visits,” said Dr Mathur.

“We have several registries running, and we are following up with the patients to know their health status, and how they are coping.”

Experts in the field say it will be a good idea if the centre comes up with consolidated guidelines to tackle this issue.

“This change is the need of the hour; I am also consulting several of my patients using digital medium, but there are no guidelines as such to refer to. Smaller centres in the periphery can take care of a patient’s immediate requirements as you don’t always need to come to a super-speciality hospital. Some hospitals may be following this mechanism right, even reducing medicine dose based on patient requirements, now also but the process will get standardized if there are centre-issued SOPs{standard operating procedures} in place,” says Dr PK Julka, senior medical oncologist, Max Healthcare.

As of now, the existing patients have been provided a list of precautions that they must take to keep their symptoms in control.

Patients should continue to take prescribed medication regularly; keep in touch with their treating doctor, and not alter the medication without the doctor’s advice, the initial advisory says.

A buffer stock of at least 1-month’s medication at home should be maintained; and in case there is any change in health condition due to the disease, the patient should visit the nearest non-Covid hospital immediately. The advisory prohibits smoking and consuming alcohol, and lays emphasis on eating a healthy and balanced diet, and remaining active as far as possible. It is best to keep a routine exercise schedule that can be maintained even at home, it says.

“It will take some time before comprehensive guidelines in this regard are released; till such time we come out with the final document, existing patients must take care of these dos and don’ts maintain their health,” said Dr Mathur.

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