• COVID-19 Treatment

    Treatment for High-Risk Patients

    Family physicians and care teams are critical to assuring that patients are vaccinated against SARS-CoV-2 infection, and it is important that patients are tested, diagnosed, and treated in a timely manner. Educating patients about the importance of preventative measures to mitigate the virus is vital, especially for those who are at high-risk of complications from COVID-19.

    Clinical Guidance

    Key findings from the CDC’s Preventing Chronic Disease, Public Health Research, Practice, and Policy included the following:

    • Several underlying medical conditions were associated with an increased risk for severe COVID-19 illness in adults.
    • Having more medical condition was associated with more severe COVID-19 illness and higher risk of death.
    • Obesity, diabetes with complications, and anxiety and fear-related disorders had the strongest association with death.1

    To assist family physicians and care teams in treating high-risk patients who are diagnosed with SARS-CoV-2 infection, the American Academy of Family Physicians (AAFP) has developed Clinical Guidance to help family medicine practices treat patients with underlying medical conditions, who are at higher-risk for severe COVID-19. This guidance provides an overview of COVID-19 vaccine recommendations, testing and diagnosing COVID-19, COVID-19 treatment options and recommendations, and counseling techniques.

    Conversation Guide: Shared Decision-Making Considerations for COVID-19 Treatment

    Shared decision-making between a patient and their physician is an important aspect of medical care. It involves you and your patient working together to make decisions about their treatment plan based on the best available evidence.

    Benefits of SDM include increasing the patient’s understanding of their condition and available treatment options, improving patient-physician communication, building trust and increasing patient satisfaction. Research has also shown that prioritizing patients’ involvement in clinic visits and encouraging them to take a more active role in decision-making leads to positive health outcomes.

    A collaborative approach can be particularly useful when you are treating patients who are at higher risk of severe COVID-19 outcomes.

    Conversation Guide: Early Treatment for COVID-19 in High-Risk Patients

    As you care for COVID-19 high-risk patients, it is important to strongly recommend the importance of early detection if they catch the virus. The Centers for Disease Control and Prevention issued a report finding that during January–August 2023, adults aged ≥65 years accounted for 62.9% of all COVID-19–associated hospitalizations. Most hospitalized adults aged ≥65 had multiple underlying conditions. Only 23.5% had received the recommended COVID-19 bivalent vaccine.

    Now that there are approved and effective therapeutics for COVID-19, patients need clear guidance. To guide these conversations, the American Academy of Family Physicians has created this conversation tool to assist you. 

    Step 1: Embrace an understanding and collaborative approach by encouraging your patient to participate in the conversation and give feedback.

    Consider cultural factors and family dynamics when discussing COVID-19 infection, testing, and therapeutics.

    Step 2: Discuss underlying medical conditions and increased risk of severe COVID-19 outcomes.

    Explain how COVID-19 infection in people at higher risk can cause severe illness and can lead to hospitalization or death.  Explain the importance of timely testing and diagnosis as well as managing COVID-19 symptoms and taking preventive measures. Helping them create a personal plan to prepare in the event they catch the virus is a great preventive approach.

    Step 3: Use motivational interviewing techniques.

    If your patient is hesitant to get tested for COVID-19, diagnosed and treated in a timely manner, ask questions to identify the reasons for their hesitancy, find common ground with your patient, and understand their reasoning so that you can help move them toward the desired outcome. Be curious, compassionate and empathetic.

    Step 4: Respond to questions and concerns about their health.

    Address your patient’s concerns and questions about health issues by providing appropriate scientific information or referring them to a reputable source. Explain how essential it is for your patient to be up to date on COVID-19 vaccinations and take preventive health measures to protect themself, their family, and their community.

    Every intervention counts. Every life saved is a victory. Let’s unite in this global effort, equipped with evidence-based interventions, to turn the tide against COVID-19. Together, we make a difference.