Tele-assessment for HRT

Consultant gynaecologist, Mr Mike Savvas explains how his patients are still receiving care through lockdown via tele-health. There needs to be realism applied to what can and what can't be done over the phone and many specialists are having to adapt to the challenges being faced.

Supporting wider gynaecological and reproductive health needs in lockdown

The COVID-19 pandemic and associated ‘lockdown’ have had a profound effect upon the way that we all live and work. We have all had to make adjustments to our normal routines and work practices, and it seems likely that this will continue for some time yet. The primary consideration over the last few weeks has quite rightly been focussed on ensuring that transmission of the virus is minimised and that every possible care is provided for those who require hospital treatments. However, it is also important to stay both physically and mentally healthy during this time and wider health needs should not be ignored.

Menopause and tele-consultations

At The London PMS & Menopause Clinic we are doing everything that we can to ensure that we still provide a service for both our existing and new patients through the use of tele-health. In fact, we have always provided a level of tele-consultations as assessing the symptoms of the menopause can often be handled reasonably satisfactorily over the telephone. Our most recent experience has shown that this approach can work well.

Indeed, we seem to be getting a good response from our patients to the new, albeit reduced level of service, which is fantastic. We are keeping very busy performing full tele-consultations as well as taking quick tele-queries (as before, we provide the latter service free of charge).

Hormone prescriptions based on tele-assessment

Face to face consultations will always be preferred of course, as they have the major advantage of being able to include scans, examinations, smear tests and other relevant diagnostic tests. But in these difficult times, these full consultations can be delayed for a few months. We can still make adequate assessments for both new and follow up patients with arrangements put in place for tests to be done later. In the meantime, we can provide repeat prescriptions with any changes to the dose required based on the tele-assessment.

Some of our patients have HRT in the form of implants with a new implant every six months. For those women for whom an alternative treatment would not be suitable a limited service is being made available, and patients should contact the clinic. For other patients requiring a replacement alternative treatments are available with a view to replacing the implants within the next month or two.

We have also been able to ‘see’ new patients and based on the tele-assessment, have prescribed HRT where necessary. Sometimes the patient will have blood results from previous testing plus other investigations such as scans arranged via their GP or another doctor, and these can be helpful. In many cases we are able to prescribe HRT for three months and arrange a review date, for when we hope that some restrictions will be lifted.

As far as the technology is concerned, the telephone is fine as this also keeps potential issues of confidentiality to a minimum. We are also still working with patients’ GPs and sending letters subject to consent, of course. We are also providing our patients with a lot of information on our services via our new website and articles on Total Health. At the clinic we naturally have access to all relevant medical information on our patients including previous test results on our secure practice management system.