A Clinical program is only complete with diagnostic facilities in the determination of diseases with medicine supplements in completing treatments post-diagnosis. The Aarogya Vahini team extends its services through periodic monitoring, follow-ups and logistic support for referral treatments
A key component of an inclusive wellness and healthcare program is the Community pharmacy. With a competent pharmacist team and support of major Pharmaceutical organizations, the trust has been able to address to more than 15000 chronic patients month on month since 2018. The above support has had a significant impact on the beneficiaries with the sustained support in reducing not only their monthly expenses towards medicines but in controlling their vital index’ and measurable parameters for Cardiovascular & glucose levels reducing the probability of tertiary diseases.
The pharma division has touched over 53068 beneficiaries over the years , where every month the addition of chronic patients in Hypertensive – 7100, Diabetes Type II – 6700 and both Hypertensive & Diabetes – 1100 cumulatively adds to around 14900 patients who avail and gets benefitted month on month from the pharma along with the other diversified requirements of medicines
A dedicated efforts towards control of Diabetes was on of the key focus of the program: The primary symptoms looked for were
- In Type 1 diabetes, the classic symptoms are excessive secretion of urine (polyuria), thirst (polydipsia), weight loss, and tiredness.
- These symptoms may be less marked in Type 2 diabetes. In this form, it can also happen that no early symptoms appear and the disease is only diagnosed several years after its onset, when complications are already present
Diabetes in pregnancy also give rises to several adverse outcomes, including congenital malformations, increased birth weight and an elevated risk of perinatal mortality. Strict metabolic control may reduce these risks to the level of those of non-diabetic expectant mothers.
The Detection & Confirmation Methods Followed in the Program:
1st Level Screening: Patients with RBS 140 mg/dl are suspected to diabetic patients.
2nd Level Screening: Patients with FBS >126 mg/dl or RBS >200 mg/dl are screened as a diabetic patient.
3rd Level Screening: Patients with HbA1c >6.5 are screened as a diabetic patient.
4th Level Screening: Patients with RBS >350 mg/dl immediately refers to District Hospital.
Steps to increase the dose:
- Starts with tab Metformin 500mg BD( if Target not Achieved)
- Tab Metformin 750mg BD( if Target not Achieved)
- Tab Metformin 1gm BD( if Target not Achieved)
- Referred to District Hospital
- Combination therapy:
Metformin + Glimepride
- Starts with 500mg BD + 1mg OD ( if Target not Achieved)
- Tab Metformin 750mg BD + 1mg OD ( if Target not Achieved)
- Tab Metformin 1gm BD + 2mg BD ( if Target not Achieved)
- Referred to District Hospital
The main aim of this protocol to control the raised blood sugar however not to be complicated by hypoglycemia. Till now 8200 patients had been identified from the 58119 beneficiaries as diabetic patients and more than 1400 patients are regularly supported by the pharma department for their full course medicine in every month.
During the course of treatment awareness regarding the lifestyle, food habits has been also taken care of by the pharma department and followings are circulated in the diabetic awareness programs.
- Patients have not been allowed fast during the medication.
- Eat healthy foods
- Maintain a healthy weight & Increase physical activity
- Don’t smoke & drink alcohol
- Take your medications properly & checked up by consultant at periodic interval.
Hypertension (HTN) Management:
There are four stages of high blood pressure or hypertension:
- STAGE 1 or Prehypertension is 120/80 to 139/89.
- STAGE 2 or Mild Hypertension is 140/90 to 159/99.
- STAGE 3 or Moderate Hypertension is 160/100 to 179/109.
- STAGE 4 or Severe Hypertension is 180/110 or higher.
Detection & Confirmation:
1st Level Screening: Patient coming with BP above 140/90 is suspected as HTN patient.
2nd Level Screening: These patients will check twice after 15 min interval. If it become the same then it is confirmed as HTN diagnosed patient. The diagnosed patients are monitored by CHW at periodic intervals.
3rd Level Screening: Patients coming with BP above 200/110 are immediate refer as an HTN diagnosed patient. These also are monitored by CHW.
Till now 7800 patients have been identified as hypertensive patients and more than 1500 patients are regularly supported by the pharma department for their full course medicine.
Mobile Investigative equipment’s in the evaluation of vital parameters at site capable of installations inside Mobile Clinics is an added feature of the program in advance and quick diagnosis of rural patients with the lesser turn around time. So far 7373 Beneficiaries have been benefitted from the portable mobile pathology in the collation of monthly data of required profiles and spot tests for Glucose, Glycosylated Hemoglobin & Hemoglobin levels evaluations as a mandatory indicator for all above 30 years. Added to the above Electrolytes, Liver Function Tests, Renal Profiles were the fields of investigations along with ECG and Detection of Cardiac Murmurs with Cardiac Stethoscope.
|Total No Of Beneficiaries||7373|
As a dedicated Diabetes Screening Protocol, all beneficiaries above 30 years went through mandatory spots tests for Glucose followed with tests for Glycosylated Hemoglobin for the suspects for confirmation and begin treatment to be adopted under the program as a Chronic Diabetic Type II patient
|Total No Of Spot Glucose Tests||48000 +|
|Glycosylated Hemoglobin||600 +|
|Confirmed with Diabetes||2460|
|Already Diagnosed with Diabetes||15000 +|
Objectively to rule out possibilities of leukemia or any blood cancer and
to combat anemia, testing of Hemoglobin has been a mandate for a specific category of beneficiaries
- menstrual age grp wt any complaint
- postmenopausal age grp wt symptoms
- with irregular menstruation for females
- with decreased TSH level
- pallor in eyes
- bulbous fingertips
- decreased TSH Level
- complaining of fatigue and not energetic
|Total No Of Pathological Test||9600 +|
|LFT , KFT , Lipid Profile , Electrolytes|
Periodic Peer review for clinical correlation has been done during the program as an added feature to ensure the quality of the investigation.
Follow-Ups, Logistic Support & Monitoring
Community participation as promoted in the global dialogues as a vital element of a human rights-based approach to health is a guiding principle of Trust in motivating and promoting the participation of Community Health Workers through awareness and capacity building.
Consistent and periodic monitoring of over 15000 chronic patients through the clinical disease-specific investigative protocol with Community Health Workers and Door to Door Awareness on NCDs for the rural population above 30 years and Breast Cancer for Rural Women is a key activity the Trust ensures through its program.
Logistic Support for Referral Surgeries within the city is extended for the geriatrics for daycare surgeries. Inter-State transit is supported by the Terminal Stations for the patients with Ambulance facility to their villages.
Post Surgical Follow-Ups and handholding of such patients is a prime activity carried out by the members in an attempt to facilitate clinical advice & communications and precautionary measures as conveyed to rural patients, with the demonstration of post-surgical care to rural caregivers.