Chronic diseases — the impact and treatment

What are chronic diseases

Chronic diseases are conditions that last for 1 year or more and cannot be passed from person to person (they are noncommunicable). The condition can be controlled with treatment, however often they don’t have a cure. “They are of long duration and generally slow progression” states the World Health Organisation. Due to their persistence over a long period of time, chronic diseases can hinder the lifestyle of those living with it, e.g: their independence and health creating limitations to certain activities. In the UK, there are currently around 15 million people with a long term chronic condition, with 60% of people over 65 years of age living with one.

Examples of chronic diseases

• Arthritis
• Parkinson’s disease
• Cancer
• Alzheimer disease and dementia
• Asthma
• Epilepsy
• Diabetes
• Heart disease
• HIV/AIDS
• Hypothyroidism

Living with a chronic disease

Sadly, the prolonged course of illness causes people with chronic diseases to be two to three times more likely to suffer from depression than the general population. Conditions such as stroke or Parkinson’s disease can cause changes to the brain which may have a direct role causing depression. Limitations on usual activities can cause frustration whilst anxiety looms over the thought of treatment outcomes and the future. There may be a risk of downward spiral where someone with a chronic illness may stop looking after themselves (e.g: not taking medication or keeping up with a good diet and exercise). When dealing with a chronic disease, it is essential that the person take good care of themselves whilst trying to keep positive.

A way to cope with your illness, that has proved helpful, is to share with and learn from people who are dealing with a similar disease. Finding a support group or being part of an online blog and discussion group can give you comfort in the fact that you are not alone.

Treatment for chronic diseases

Treatment for long lasting illnesses can include physical therapy, psychological therapy, surgery, radiotherapy etc… however the most common form of treatment for chronic diseases is medication. But with medication, comes treatment burden. Treatment burden is the patients discernment of the effort needed to manage their chronic disease and the impact it has on their day to day life, e.g: taking medication regularly, booking healthcare appointments and self-monitoring their health. To reduce treatment burden, the healthcare system has made collecting medication a more efficient process. Most pharmacies offer medication sychronisation which means all of a patient’s prescriptions are arranged so that they can all be refilled on the same date. Therefore, rather than patients having to visit the pharmacy multiple times for multiple different prescriptions, they can collect their medication at a certain time in one go, thus reducing stress, time and the ‘burden of treatment for the patient’.

In an effort to reduce treatment burden, the company Lyft (a ride sharing app) has coordinated with healthcare teams to transport older, more frail, patients to their medical appointments. This will reduce any anxiety for senior patients caused by the thought of reaching their appointment, therefore reducing their treatment burden.

A doctor’s view

I reached out to Dr Meeta Duggal (a GP in London) to gain some perspective from a doctors point of view. I got some valuable insight into how medical professionals deal with patients with long term conditions (LTC). The government wants GPs to optimise patient care by making sure they have annual blood tests, blood pressure checks, height and weight checks, diet advice etc… Once a patient has been diagnosed with an LTC they are referred to the GP, whose practice has an annual recall system. This is when the patient gets an invite to book an appointment with their nurse to get their routine checkup (e.g: i have hypothyroid, so i need an annual thyroid blood test).

There is additional work for both the GP and the patient when medication changes as new monitoring has to take place. For example: whenever the dose of the blood pressure medication — ramipril — is changed, a blood test is required 2 weeks after. This blood test needs to be constantly carried out each time the dosage of the medication is changed to check what suits the patient. However, some patients do not like having repeated blood tests and hence don’t engage much with doctors, so GPs try to keep it as easy as possible for patients.

Fatal to chronic — HIV

HIV is a notorious disease that was known to be fatal but since 1996 has become treatable. There are currently over 100,000 people living with HIV in the UK. Despite there being no cure, the disease that was once considered a ‘death sentence’ has been transformed from a fatal infection to a chronic disease via antiretroviral therapy. This shows a positive outlook on chronic diseases and that despite it having negative connotations, it may have provided a longer life to those diagnosed with HIV.

Sources

• UK country health profile 2019
• Statista: Diseases — Statistics & Facts
• Chronic illnesses and mental health
• Reducing patient burden through health policy
• Living with chronic illnesses
• What are chronic diseases
• The end of AIDS: HIV infection as a chronic disease

By Kashvi Sahay