The COVID-19 pandemic has left patients with ongoing symptoms from their battle with COVID. Long-hauler symptoms have challenged healthcare professionals to find ways to help patients manage their symptoms with little research. Parkview Health, serving the northeast Indiana and northwest Ohio region, responded to this need by creating the Parkview Post-COVID clinic where patients are seen by a multi-disciplinary team. The clinic team consists of neurology, pharmacy, physical medicine and rehabilitation, neuropsychology, nursing, and physical therapy. Patients are evaluated on their top five ongoing symptoms that they are the most concerned about. Some of the most common symptoms seen are fatigue, brain fog, and continued shortness of breath.
The Parkview Post-COVID clinic is a consultative clinic, currently limited to referrals from Parkview Physicians Group. After their initial visit, patients are seen for follow-up visits at the discretion of the provider. Patients most often receive follow-up care if they start a new medication. Beyond any clinical care, the Parkview Post-COVID clinic offers a support group hosted once a month by a nurse within the clinic. The Parkview Post-COVID clinic also partners with the Parkview Mirro Center for Research and Innovation for research opportunities.
As our knowledge of caring for post-COVID patients evolves, the roles of multidisciplinary team members change and grow. Currently, the pharmacist completes a complete medication review with the patient. A chart review is also done to evaluate any recent medication changes or hospitalizations. Medication lists are assessed for appropriate dosing and therapy. The pharmacist is also evaluating to see if there are any medications that could potentially be worsening any ongoing symptoms the patient is still experiencing. Recommendations are made to the providers in the clinic or are sent to primary care providers. Recommendations range from getting updated labs to evaluating medication appropriateness or dosing. During the patient interview, the pharmacist also discusses the COVID-19 vaccine. If patients are not vaccinated, they are counseled on current vaccination recommendations.
As a clinic pharmacist, I have noticed a few common trends where I have been able to positively intervene. Many patients have started taking multiple vitamins and/or supplements in hopes of finding relief from their ongoing symptoms. I have been able to counsel these patients on the current recommendations of vitamin/supplement use in post-COVID patients, which currently does not carry much data.
Another area of need I have seen is counseling on inhaler use. Many patients are sent home from the hospital with maintenance and rescue inhalers without education on their purpose or how to use them. After counseling, patients better understand the importance of taking inhalers as instructed and can properly use them to hopefully improve their breathing symptoms.
Finally, I often find myself encouraging patients to stay involved in their healthcare. I have worked with multiple young patients who have been started on many new medications since their COVID diagnosis in the hopes to alleviate ongoing symptoms. I always encourage them to talk with their physician about re-evaluating the need for certain medications as their symptoms start to resolve.
As we begin to move from a pandemic to an endemic state for COVID-19, we eagerly await more data and research on how to best care for these patients and treat their ongoing symptoms.