Many patients with chronic diseases who have been treated and are stable want to increase the prescription period from a maximum of 30 days to a maximum of 60 days - Photo: THU HIEN
Recently, Vietnam Social Security proposed to increase the time for prescribing drugs to treat stable chronic diseases (diabetes, hypertension...) to a minimum of 60 days and a maximum of 90 days, instead of 30 days as present.
Tuoi Tre Online has recorded how difficult it is for chronic patients to visit hospitals today.
The difficult path to re-examination for chronic patients
Having suffered from heart disease and high blood pressure for more than 10 years, Ms. D.TT (74 years old, Binh Chanh district) has to regularly go to the hospital for check-ups to get a prescription from the doctor. The distance from her home to the hospital is more than 20km.
Every time she goes to the hospital, Ms. T. usually wakes up early at 5am, cleans up her things to be on time at 6am to catch the first bus from Binh Chanh to Nguyen Trai Hospital (District 5) for a follow-up examination.
To get to the hospital, she had to change buses three times in a row. Previously, the doctor told her to come for a check-up once a month, but now it's once every three weeks.
"I woke up early in the morning to take care of family matters, then went to the hospital at 10am. The examination took at least 4 hours.
Each time I go to the doctor it takes all day, by the time I get home it's already 4-5pm.
Many of my friends and relatives also have check-ups every 3 weeks, but sometimes they don't have the time or conditions, so by the 4th or 5th week they often go out to buy medicine or buy medicine according to the doctor's prescription, and rarely return to the hospital for check-ups on time," Ms. T. confided.
Ms. T. also added that for chronic diseases that have been treated and stabilized, the types of medications used for follow-up visits are the same, but it takes time and effort to go to the hospital every 3 weeks for a follow-up visit, which will be difficult for the elderly.
Similarly, the case of Ms. NNH (70 years old, District 8) who has been diagnosed with diabetes for nearly 10 years said that she is also required to have a follow-up examination every 3 weeks. However, the 3-week follow-up examination time passes very quickly, and traveling is both time-consuming and costly.
Ms. H. said that when going to the doctor, many people her age had to take a bus from far away provinces like Ca Mau and Bac Lieu, which was very difficult.
"I have a friend who, every time he goes to the doctor, cannot take a bus, he has to take a taxi. The examination fee is not much, but the taxi fare alone is more than 2 million VND. There are patients who live far away, go late at night, come in the morning, wait for the examination to be finished, then go back when the examination is due. This is both time-consuming and costs too much in travel expenses.
"Check-ups and medication every two months are very suitable for them. We need to be flexible. If the illness is mild, we can increase the prescription time. On the contrary, if the illness is severe, we have to go for regular check-ups under the supervision of a doctor," said Ms. H.
According to Tuoi Tre Online , on the morning of April 22, at Nguyen Trai Hospital (HCMC), many elderly people with chronic diseases showed up early to be examined.
Most of the patients are elderly, suffering from diseases such as heart disease, diabetes, blood pressure, arthritis, etc. Many elderly people still have to take a taxi to the hospital for examination because they do not have family members to take them.
The degree of chronicity should be considered.
Talking to Tuoi Tre Online, Dr. Tran Quoc Hung - Director of District 8 Hospital (HCMC) - said that at the hospital, chronic patients who come for examination and treatment account for about 50% to 60%, mainly diseases such as diabetes, high blood pressure, heart disease, etc.
For patients with stable chronic disease, increasing the prescription period from a maximum of 30 days to a maximum of 60 days will benefit patients in the following cases: mild hypertension using 1-2 types of drugs.
However, for severe cases such as severe diabetes requiring injectable medications, severe hypertension requiring high doses of medication, COPD, etc., increasing the prescription period to 60 days will not be beneficial for the patient.
According to Dr. Hung, currently, most chronic cases that have been examined at the hospital are not mild, but rather severe, so if the prescription time is adjusted, it needs to be carefully considered.
In addition, if a long-term prescription is given, the patient becomes seriously ill and returns to the hospital for a re-examination and is prescribed a new medication, which will waste the old medication and make it difficult to manage the medication.
Besides, if prescriptions are given for a long time without control, it can lead to profiteering and taking the medicine out to sell because the quantity of medicine is large.
Researching and considering proposal to increase prescription time for chronic patients
Mr. Nguyen Trong Khoa - Director of the Department of Medical Examination and Treatment Management (Ministry of Health) - said that during the COVID-19 pandemic due to social distancing and disease prevention, the Ministry of Health has implemented outpatient drug provision every 3 months.
However, to fully adjust, we need to consider the benefits and risks. The benefits are that people reduce travel time and hospitals reduce the burden.
Prolonged prescription time can also lead to the risk of the patient not being examined for a long time, not being able to closely monitor the disease progression, which can affect treatment.
"We are considering studying this proposal and will adjust the documents and circulars guiding prescription times," said Mr. Khoa.
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