The National Institute for Health and Care Excellence today (May 15) published new rapid Covid-19 guidelines to maximise safety of patients with chronic kidney and interstitial lung diseases during the pandemic.
Written for practitioners, staff and commissioners of health and care sectors, the NICE recommendations include advice from specialists working in the NHS with expertise and experience of treating patients with the two diseases.
NICE said each of the two separate guidelines “aims to help healthcare professionals determine what care should be provided for people without COVID-19 infection or with confirmed or suspected COVID-19 infection safely and enable services to make the best use of NHS resources.”
Guideline for chronic kidney disease (CKD)
The guideline on CKD recommends that patients, including those who have symptoms of COVID-19, should be advised to continue taking their medicines as normal unless advised to stop by their healthcare professional.
Patients who are stable on treatment should be assessed to see whether it is safe to reduce the frequency of routine kidney function tests, taking into account any comorbidities and whether their CKD is progressive.
The guideline also encourages self-monitoring and self-managing (including blood pressure monitoring) by patients.
Guideline for interstitial lung disease
The guideline on interstitial lung disease provides clinicians with advice on how to adjust care to reduce patients’ exposure to COVID-19 and how to balance the risks and benefits of taking drugs that affect the immune response during the pandemic.
Since bronchoscopy and pulmonary function tests have the potential to spread COVID-19, NICE highlights that these should be carried out if the patient urgently needs them.
Patients already taking antifibrotic drugs should be advised to continue as there is no evidence that they increase the risk of getting COVID-19.
Pharmacists supplying medicines are advised to plan how to manage any disruption to normal routes such as homecare medicine delivery services.
Practitioners are advised to prescribe enough medicines to patient’s clinical needs but are warned that prescribing larger quantities of medicines puts the supply chain at risk.
According to NICE, the guidelines are produced in collaboration with NHS England and Improvement and a cross-specialty clinical group, supported by the specialist societies and royal colleges.