Tips on managing chronic diseases during pandemic


THE World Health Organisation says non-communicable diseases (NCD), including heart disease, stroke, cancer, diabetes and chronic lung disease, are collectively responsible for almost 70% of all deaths worldwide.

NCDs, also known as chronic diseases, are the leading cause of death and morbidity among Malaysian adults.

Only 41% of patients have their asthma under control, says  Dr Helmy Haja.Only 41% of patients have their asthma under control, says Dr Helmy Haja.

This has resulted in the formulation of a National Strategic Plan for Non-Communicable Diseases 2016-2025 to address the threats posed by NCDs in Malaysia.

To combat this Covid comorbidity crisis, Switzerland-based pharmaceutical company Novartis hosted a Zoom event entitled “Non-communicable diseases in the new normal”.

Novartis Corporation patient access and government affairs country head Azwar Kamarudin, in her welcoming remarks, said they had roped in three doctors to share their experience and knowledge of three diseases.

Kicking off the session was Pantai Hospital Kuala Lumpur consultant pulmonologist Dr Helmy Haja Mydin, who discussed asthma as a heterogeneous disease, and explained various conditions of asthma patients.

“What you see in an asthmatic patient is inflamed or swollen airways, ” he said, elaborating that some people would experience difficulty in breathing, chest tightness, wheezing and coughing.

Citing scenarios, he said that there was exercise-induced asthma as well as attacks triggered by changes in temperature. Allergy-induced asthma, he highlighted, was “very specific to an individual”.

Pointing to the situation in Malaysia, he said only 41% of patients had their asthma under control.

“This means they don’t need an excessive amount of reliever inhaler and their asthma does not affect their day-to-day activities, ” said Dr Helmy Haja, who is also head of the private hospital’s lung centre.

While talking on “Asthma in the New Normal”, he said inability to control asthma symptoms with the available treatment options was one of the main risk factors for exacerbated and uncontrolled asthma.

Citing findings on productivity loss, he said 48% of Malaysian patients had missed work or school due to asthma, with an average of 11.2 days away in 2010.

“Malaysians reported an average productivity drop by 21% when their asthma was at its worst, ” he said.

He stressed that correct use of reliever inhaler was important.

“Patients with asthma must take the right inhaler regularly with the right technique. Use a controller inhaler if necessary. Don’t depend on a reliever.”

On the indirect impact of the Covid-19 pandemic on asthma, Dr Helmy Haja said it caused less interaction with doctors.

He said that sometimes the use of masks and sanitiser as well as an unconducive work-from-home environment, increased indoor exposure and stress or anxiety, among others, affected asthmatic patients.

To a question from a participant at the event, he said there was no cure for asthma but it was very controllable.

“Asthma affects many people. Poorly-controlled asthma can lead to poorer health outcomes, impaired quality of life and even death.

“The risk of complications from Covid-19 is less if the asthma is well-controlled, ” he added.

Dr Helmy Haja said it could be difficult to differentiate between an asthma attack and Covid-19 symptoms.

“If you have fever, cough and sore throat, get a swab test done to find out (the cause), ” he advised.

Cardiac Vascular Sentral Kuala Lumpur consultant cardiologist Dr Choo Gim Hooi shared his insights on the topic, “Hypertension in the New Normal.”

Dr Choo says hypertension is a silent killer and if untreated, can cause various complications.Dr Choo says hypertension is a silent killer and if untreated, can cause various complications.

Dr Choo said hypertension was a silent killer if untreated, and that it caused various complications.

“Hypertension is the main contributor to cardiovascular (CV) disease burden worldwide.”

He advised patients to measure their blood pressure and said that in general, hypertension was when clinic measurement was consistently above 140/90mmHg.

“Risks associated with blood pressure is a continuum. Controlling hypertension prevents and improves outcomes and saves lives, ” said Dr Choo, who is also board member of the Asian-Pacific Society of Interventional Cardiology and National Heart Association of Malaysia and Interventional Cardiac Society of Malaysia council member.

“During the Covid-19 pandemic, CV disease patients, including hypertensives, continue to be a high risk for adverse events.

“In addition, they are at higher risk of getting a more serious manifestation of Covid-19 and dying from Covid-19 infection.”

Among others, he said that fear of Covid-19 and access barriers to medical care resulted in failure or delayed attention to CV disease and risk factors.

He added that defaulted medical follow-up and prescription refills had resulted in excess deaths.

Dr Choo advised all hypertension patients to wear a face mask, sanitise their hands regularly, maintain physical distancing, boost their immunity and rest well. “Adopt a healthy lifestyle and diet, and ensure your blood pressure is well controlled. See your doctor regularly. Make sure to take your medication, ” he said.

Meanwhile, Gleneagles Hospital Kuala Lumpur consultant dermatologist Dr Peter Ch’ng Wee Beng spoke on “Psoriasis in the New Normal.”

“Talk to your dermatologist if you get psoriasis during this Covid-19 period. Don’t stress too much as it will become worse, ” he pointed out.

He said those with the skin condition should not smoke or drink alcohol excessively.

“Remember to exercise. Take up a new hobby and enjoy time with your family, ” advised Dr Ch’ng, who is also Cosmetic Dermatology and Laser Medicine Board of Malaysia chairperson.

He shared that some of his patients abroad and from other states in Malaysia could not seek treatment during the initial movement control order period.

“Some had financial difficulties and had to cut down their medication and because of this, their psoriasis became more severe.”

Asked if moisturiser could aggravate psoriasis, he said ideally, it should not contain fragrance, preservative and colouring.

“The most important thing is that the patient finds the moisturiser soothing.”

Asked if psoriasis would worsen with age, he said although there was no evidence to back this up, on a personal level his father’s condition improved as he got older.

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