Follow-ups are vital when treating chronic diseases, UAE doctors say



ABU DHABI // Frequent follow-ups are crucial when treating chronic diseases, doctors say.

This is especially true in a country where the prevalence of metabolic and cardiac conditions is high.

"It is very difficult to confirm whether any particular disease is definitely stable," said Dr A George Joseph of New Medical Centre Specialty Hospital in Abu Dhabi. "Diseases like cardiovascular disease, hypertension and diabetes are very dynamic. The blood has to be continuously monitored."

With compulsory insurance in Abu Dhabi, Dr Joseph believes there is no reason for patients not to have the best health care - a cornerstone being doctor-patient interaction.

"If you are seeing a patient more frequently you are definitely giving him better overall care," he said. "At each visit, some sort of education is passed on to the patient."

Liability is also an issue, Dr Joseph said, because doctors can be held responsible for a complication that arises after a long gap between consultations.

"The regulations are very strict and the doctor may be questioned as to why he hasn't followed up with the patient for a very long time," he said. "Because of these regulations, doctors become more protective."

Dr Joseph said most of his chronic cases were unpredictable, making it all the more important for him to conduct frequent follow-ups.

Dr Tarek Abdul Azeem, a professor and consultant of internal medicine at Al Noor Hospital, said two key aspects must be investigated with each consultation: the disease itself and the medication.

"Medication needs re-evaluation. There might be side effects, complications might arise, the dose might need to be changed or the medicine discontinued altogether," he said.

Progressive diseases, such as diabetes, must be continuously monitored in case treatment needs to change and to prevent severe complications. He said: "As well as making sure the patient is following instructions, doctors must confirm the patient's non-pharmacological therapy, which pertains to lifestyle, such as diet and exercise."

Having a centralised prescription system helps to monitor refills and protect patients from drug errors, health officials say.

The Pharmacy Benefits Management database, which was introduced last September, allows both Haad and insurance companies to ensure there are no duplications or negative drug-to-drug interactions between prescriptions.

"The pharmacist, before dispensing, sends an electronic record to the health authority that gets automatically verified against the patient's history and previously dispensed drugs," said Dr Mahmoud Ramadan Abu Raddaha, head of prices and product benefits section at Haad.

If there are any problems, the dispensing of drugs is stopped immediately. The system also makes it easier to refill repeat prescriptions.

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