Q&A: Treating patients with long COVID requires patient-centered communication
Though evidence for long COVID treatments is lacking, patients have been voicing a need for more understanding and better communication about their situation, according to an expert.
Recent research has indicated that nearly 19 million adults in the United States may have long COVID and about 18% of people with the condition have been unable to return to work since their diagnosis. The most common symptoms include headache, fatigue and brain fog, but there are many others that can be tied to long COVID.
Carina Klocke, MSc, a scientific associate at the University of Tübingen’s Institute for General Practice and Interprofessional Care in Germany, and colleagues wrote in Annals of Family Medicine that there is currently no evidence that shows the benefit of specific therapies for long COVID, and patients typically rely on self-initiated therapies.
They conducted an online questionnaire to learn more about the symptoms patients are experiencing and what kind of treatments they use to alleviate them.
About 500 participants responded, and the data suggested several approaches were beneficial, like respiratory therapy and mind-body medicine. The researchers also found that there is “a great need for patient-centered communication” such as more recognition of long COVID.
Klocke spoke with Healio about the study findings, what primary care physicians can learn from them and more.
Healio: What were the most common symptoms and approaches that helped alleviate those symptoms?
Klocke: The most common symptoms were fatigue, poor concentration, psychological impairments, shortness of breath, headaches and loss of smell or taste. Patients tried various therapeutic approaches. For example, patients with respiratory problems tried mind-body medicine, respiratory therapy or non-cortisone-containing inhalants. Patients with fatigue tried sports/exercise as well as rest and nutritional supplements. These approaches were rated helpful by some patients. However, our study does not allow any conclusion if these approaches would be generally effective. This should be investigated by clinical trials.
Healio: Why is patient-centered communication so important for patients with long COVID?
Klocke: So far, evidence for the effectiveness of therapies for post-COVID symptoms are lacking. At the same time, patients express their need for more and broader understanding of their situation. In order to close this gap and to ensure comprehensive and trustworthy care over the long term, discussing the post-COVID syndrome in the context of patient-centered communication is important.
Healio: This study was conducted in Germany — do you think the findings are applicable to the U.S. health system?
Klocke: The health care systems of both countries are very different, eg, Germany has a strong primary care system in which general practitioners play an important role and are the first point of contact for the majority of all patients. Nevertheless and for now, physicians are considered to have only limited possibilities in dealing with the new disease post-COVID, and this may also be transferable to other health care systems. It would, of course, be interesting to conduct a similar survey in other health care systems.
Healio: You found that 33% of patients said there is a need for specific post-COVID-19 health care services. Do you think this is possible? What would it ideally look like?
Klocke: Post-COVID is a challenging disease for many reasons: on the one hand, its symptoms are very heterogeneous and thus almost always require an individually tailored approach. Second, we are only at the beginning of gaining experience in dealing with this new disease. Hence, we need to create platforms for interprofessional and cross-sectoral exchange of experience to strengthen competence in the care of post-COVID, even for those who rarely see patients with post-COVID in their practice. Family physicians must and can remain the most important contacts here, as they have always been experts in nonspecific complaints.
Healio: What are the clinical implications of your findings?
Klocke: Our survey aimed to provide a descriptive overview of therapies that patients use against their symptoms, even self-initiated. Our findings do not allow us to draw conclusions about how well or poorly these therapies work against post-COVID. Here, we need clinical studies that specifically investigate the benefits.
Healio: What is the take-home message for primary care providers?
Klocke: To keep an eye on their patients’ individual needs concerning their post-COVID symptoms and to listen carefully is what might give patients a better feeling of being understood and at the same time one of the main needs expressed by the participants of our survey.
Healio: Is there anything else you’d like to add?
Klocke: Our study does not cover a representative sample. But nevertheless, our crowdsourced approach was a low-threshold way to picture the situation and experiences of many patients with post-COVID in a short period of time and to illuminate their specific needs.