Definition and Overview
Pulmonology follow-up refers to subsequent visits to a pulmonologist, a doctor who specializes in lung diseases, particularly those that affect the upper respiratory tract. To a certain extent, pulmonologists also deal with lung conditions that affect the heart.
Who Should Undergo and Expected Results
A pulmonology follow-up may be recommended if:
The lung disease is complex - Not all types of lung diseases require a pulmonologist. More often than not, simple lung problems are diagnosed and treated by a general physician. Patients are referred to pulmonologists only when lung diseases have become more complex or beyond the scope of the primary doctor. This means that the disease is more difficult to treat and manage due to its nature, the age of the patient, and other factors that can affect the patient’s overall health and well-being. The disease may also be further compounded by the presence of preexisting conditions such as HIV or AIDS.
The patient is under medication – One of the most effective ways to deal with a pulmonology problem is through medications. For example, antibiotics are often prescribed during a tract infection. Drugs, however, need constant monitoring to ensure they are taken as directed. If necessary, the drug dose and even the entire prescription can be changed by a pulmonologist, depending on the patient’s response.
The patient has undergone surgery – Different types of surgeries can be performed on patients that have pulmonary problems, including a lung transplant. Surgeries have certain risks and complications such as bleeding, infection, or, in the case of organ transplant, rejection, which need to be managed or prevented.
The patient is newly discharged from the hospital – In the hospital setting, it is much easier for the pulmonologist to monitor the progress of the patient, especially since the environment is more controlled. Once the patient has already been discharged, he can be influenced by factors that may worsen his condition. A follow-up is then carried out to immediately assess the patient’s health once he returns to his normal activities and environment.
Lifestyle change is needed – Many lung diseases, such as emphysema, require major lifestyle changes to make them more manageable. One of the biggest modifications is smoking cessation. The follow-up is needed so the doctor can properly keep track of the patient’s progress or to continuously guide and instruct the patient on how to make the lifestyle change more comfortable and simpler.
Many studies have already shown the significant benefits of pulmonology follow-ups. A study conducted to assess the health condition of more than 60,000 patients who have been admitted for chronic obstructive pulmonary disease (COPD), showed a lower risk of hospital readmission and ER visits when patients participate in follow-up care within 30 days after hospital discharge. In a similar study by Ben-Gurion University Medical Center, those who failed to go through follow-up visits after a month of hospital discharge were more likely to experience readmission within three months.
How Does the Procedure Work?
Pulmonology follow-up is discussed during the initial or first consultation. If the patient is to undergo surgery, it is talked about before the operation is carried out. Due to its importance, it is crucial that doctors can make patients commit to follow-up visits. There is no specific schedule as to when the follow-up should be performed. For people with COPD, it depends on the severity of their condition. If it is mild, an annual follow-up visit is often enough. However, if the condition progresses over time, the visits will be more frequent. For moderate cases, the visits are typically scheduled 3 to 6 months apart. Meanwhile, patients with severe COPD are monitored every 2 to 4 months.
For patients who have had a lung transplant, a follow-up occurs immediately after surgery. Once they are discharged, the patient will need to visit the doctor every 2 or 3 weeks over a course of several months while the doctor assesses the transplant’s stability. If it is already stable, a new follow-up plan may be created, in which the patient is required to visit less frequently except in cases where he develops signs and symptoms, such as fever, that may indicate organ rejection.
During the follow-up visits, the doctor will obtain updated information on the patient’s personal and family history, any improvement on health or presence of new or worsening symptoms, response to medication or treatment, and other concerns. If needed, the patient may undergo certain tests such as blood and imaging exams like X-ray for a more accurate monitoring.
Possible Risks and Complications
Not all patients can commit to a follow-up for a number of reasons such as the distance of residence, the severity of the condition, age, and socioeconomic status.
- Mason, R. Murray and Nadel’s Textbook of Respiratory Medicine, 5th edition, Saunders, 2010.