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How to strengthen chronic conditions management with POC testing

Pre-pandemic, chronic conditions management could be easily discussed and tested during a routine well visit. But when people sheltered in place during the onset and continuation of the COVID-19 pandemic, many people skipped in-person well visits with their healthcare providers.

Instead, most providers either rescheduled in-person visits for months or else pivoted to offering telehealth visits. Though such care provided some medical oversight, particularly for those who need chronic conditions management for illnesses such as diabetes, hypertension and hyperlipidemia, many patients went without the routine lab testing that shows how well patients are managing these conditions.

Common point-of-care (POC) tests offered at physician offices include those for pregnancy, strep, blood glucose and hemoglobin A1C, according to an article from the American Association for Clinical Chemistry.1 

How chronic medical issues worsened during the pandemic

Research supports the sudden decline (by rates ranging from 81% to 90%) in preventative screening for low-density-lipoprotein (LDL) cholesterol levels and hemoglobin A1C in March and April 2020, and subsequent drops (of rates ranging from 52% to 60%) in new prescriptions for statins and metformin in a study published in the Journal of General Internal Medicine in September 2020.2

The study's authors looked at two large healthcare institutions from February to May 2020. They noted that "preventive services, routine monitoring and treatment of lipid disorders and diabetes, though likely safer to temporarily defer during the current COVID-19 crisis...have been shown to be lifesaving. The cumulative risk over time may be significant. A number of patients who might have otherwise been detected and treated earlier [could] likely present to the ED with new or dangerously out-of-control diabetes. However, the real concern is the longer-term population-based consequences of failure to detect, prevent and treat conditions, such as diabetes and cardiac risks from hyperlipidemia."

Corresponding author Adam Wright, Ph.D., of the Department of Biomedical Informatics at Vanderbilt University Medical Center in Nashville, TN and co-authors from Brigham and Women's Hospital and Partners Healthcare (both in Boston) all noted in the study that similar gaps in care occurred due to the pandemic. Examples of this include patients needing immediate care for stroke or myocardial infarction as well as cancer treatment and childhood vaccinations.

Other studies showed the pandemic affected screenings and other forms of chronic conditions management as well, including for hepatitis C3 and inflammatory bowel disease.4

A May 2020 poll by the Kaiser Family Foundation found that 48% of Americans say they or a family member skipped medical care from March to May of that year. Notably, 11% of them say their medical conditions worsened as a result.5

It's time to resume well-care visits with providers

Launched in July 2020, the Stop Medical Distancing website urged people to keep up with medical visits in light of the COVID pandemic. A collaboration between McKesson Corporation and a host of other healthcare companies, the site explained the difference between physical social distancing to prevent viral spread, and medical distancing, or avoiding medical care altogether.

Patients need to stay in touch with healthcare providers, either through telemedicine with video visits or phone calls or in-person appointments for ongoing medical care. It's the key to maintaining good health, uncovering any undiagnosed issues and receiving ongoing care for chronic conditions. POC diagnostic tests that measure blood lipid levels, blood glucose numbers and other parameters can help physicians diagnose or provide necessary ongoing medical care.

It's been more than a year and a half since the coronavirus pandemic first reached the United States. Though COVID-19 remains a public health concern, the availability of effective COVID-19 vaccines for adults, teens and now children has helped reduce the risk of death, and the volume of those who may become seriously ill or require hospitalization. Most healthcare providers have now re-opened their offices for in-person visits, making POC diagnostics and laboratory testing available to patients who need it.


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