PHONE CONSULTATIONS DURING COVID-19

Getting the most from phone consultations with your doctor

Although the world’s health focus is on COVID-19, people who suffer a heart condition should continue to treat and manage their circumstances as a priority. While meticulous attention around the day-today virus-prevention considerations of social distancing, staying at home and handwashing ought to be adhered to, sufferers of any cardiovascular disease need to stay in contact with their cardiologist and give forethought to their medication supplies.

TELEPHONE CONSULTATIONS 1. Help you to stay in touch.

Telephone consultations are now commonplace. While they offer fantastic opportunities, they are not social calls, and there is etiquette, that when followed, helps everyone.

For telephone consultations: • know the time

• be on time, and

• be prepared for the phone call.

2. Time is limited.

Your cardiologist works to a timetable. From your perspective:

• Have the time of the telephone consultation in your diary, as you would if you were coming into the consulting rooms.

• Remember, the time of the consultation is limited.

I’ve had patients who have gone to lunch, mistaken the time, been doing something else, or who have forgotten. Trying to make telephone consultations work between face-to-face consultations is difficult, and

as with face-to-face consultations, time is restricted.

3. Prepare well for the teleconference.

These points are important:

• Make the phone call in a quiet spot so that you will not be interrupted.

• If you have issues that you would like to raise, make a list, and tell your doctor at the beginning of the call.

• Have in front of you an up-to-date list of current medications, their dosage and when you take them.

• If possible, have a speaker capacity on your phone, or an attachment, so that your significant other, your partner, perhaps your child, a carer, can participate, also.

4. Some telephone consultations are complex.

Telephone consultations can be quite complex. Not only are we dealing with involved medical issues, but we are also missing non-verbal cues and feedback. This flows both ways. Communication becomes even more complicated when the patient is relatively new, and there has been little prior opportunity to develop a rapport with the patient and anyone closely associated with the person.

While first consultations are not impossible over the phone, face-to-face remains the preferred method of meeting so that a relationship can be established.

5. Future possibilities for telephone consultations.

The opportunity for telephone consultations in the future is almost certain to remain for some patients. For follow-ups, especially if the condition is well-controlled, and particularly where the patient has issues around mobility, age, frailty or risk, over-the-phone consultations offer choice and convenience.

MEDICATIONS

The second area of interest in our COVID-19 heart world, is medications. It is essential that you:

• Organise your supply of medications ahead of when you need them.

• Do not stockpile medical products that you do not need.

Medications should be organised sensibly and thoughtfully. A 4-to-6-week supply of the medications you require would be reasonable. Speak with your pharmacist. It might even be possible to have the medications delivered to your home.

For the sake of your fellow sufferers, you should not stockpile over-the-counter medications and products that other people may need more than you.

Finally, a particular word for sufferers of hypertension and diabetes.

There have been some reports that people who take blood pressure tablets and/or have diabetes are at higher risk of contracting coronavirus. At this stage, there is no evidence that angiotensinconverting enzyme inhibitors (ACE inhibitors) or related drugs, angiotensin II receptor blockers – such as Candesartan, Irbesartan, Ramipril – add risk. While there is no recommendation, including from the Heart Foundation of Australia, to stop taking blood pressure tablets, it would be wise to ‘watch this space’ in case there is a re-evaluation. For now, though, don’t stop your meds.

SUMMARY

• Meticulously observe COVID-19 health and social requirements.

• Stay in touch with your doctors and embrace telephone consultations.

• Have a 4-6-week supply of your medications on hand, but don’t overreact and stockpile.

Dr Warrick Bishop is a cardiologist with special interest in cardiovascular disease prevention incorporating imaging, lipids and lifestyle. He is author of the book ‘Have You Planned Your Heart Attack?’, written for patients and doctors about how to live intentionally to reduce cardiovascular risk and save lives! Dr Bishop can be contacted via his website.