Enhancing the management of long COVID in general practice: a scoping review, 2022, Brennan et al

Abstract

Background Long COVID is a multifaceted condition, and it has impacted a considerable proportion of those with acute-COVID-19. Affected patients often have complex care needs requiring holistic and multidisciplinary care, the kind routinely provided in general practice. However, there is limited evidence regarding GP interventions.

Aim This study aimed to address this issue by conducting a scoping review of literature on GP management of Long COVID.

Design & setting Arksey and O’Malley’s six-stage scoping review framework with recommendations by Levac et al. was used.

Method PubMed, Google Scholar, the Cochrane Library, SCOPUS, and Google searches were conducted to identify relevant peer-reviewed/grey literature, and study selection process was conducted according to the PRISMA Extension for Scoping Reviews guidelines. Braun and Clarke’s ‘Thematic Analysis’ approach was used to interpret data.

Results Nineteen of 972 identified papers were selected for review. These included peer-reviewed articles and grey literature spanning a wide range of countries. Six themes were identified regarding GP management of Long COVID, these being: (i) GP uncertainty, (ii) Listening and empathy, (iii) Assessment and monitoring of symptoms, (iv) Coordinating access to appropriate services, (v) Facilitating provision of continual and integrated multi-disciplinary care and (vi) Need to facilitate psychological support.

Conclusion The findings show that GPs can and have played a key role in the management of Long COVID, and that patient care can be improved through better understanding of patient experiences, standardised approaches for symptom identification/treatment, and facilitation of access to multidisciplinary specialist services when needed. Future research evaluating focused GP interventions is needed.

Open access, https://bjgpopen.org/content/early/2022/03/06/BJGPO.2021.0178

 

The vast majority of long haulers would strongly disagree with this aspirational statement. They would wish it were true, but it isn't. So finding the opposite of reality, high quality uncut hopium, in research papers points out to a major issue of discrepancy between reality and perception of reality in health care. It's explicitly the failed model of siloes and uncoordinated care that is failing patients, the standard approach for general medical practice. GPs aren't even trained on this anyway so how could that even work out?

The first step in fixing a problem is to acknowledge it. Here we have the exact opposite, reality is turned on its head and widespread failure is actually good and jolly and only needs a little enhancement here and there.

Also notable that access to psychological services is not an actual problem. Access to competent services that actually understand the issue, now that's the actual problem. Because of institutional failures, this usually only exists from therapists who are themselves disabled or chronically ill, education just isn't the same as lived experience. And even then the vast majority of people need tangible support, food, shelter, security, money, well before they need any of this, at least the patient communities are providing some of this.