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Chapter 16 / Complete chapter

Managing Chronic Illness

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Chapter 16 editorial cartoon: Your body is a long project, not a weekend sprint. Enlarge illustration
Your body is a long project, not a weekend sprint.

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Editorial cartoon · Chapter 16Your body is a long project, not a weekend sprint.

Original illustration with Chinese lettering; the English dialogue is below. Humour is a reading aid, not evidence.

English dialogue
  • Can we finish it all today?
  • Let's follow the plan.

Take medication exactly as prescribed — don’t stop just because you feel better

People who consistently follow their doctor’s instructions when taking medication have roughly half the risk of dying during the same period compared …

Cost
There’s no cost at all; in fact, it saves money on future treatment for complications. Tak…
Benefit
This finding comes from a meta-analysis that pooled data from 21 separate studies involvin…

First get outpatient chronic disease certification, then register for cross-regional medical care — hypertension, diabetes, cancer radiotherapy/chemotherapy, dialysis, and anti-rejection treatment can then be covered by yibao across regions

Patients with hypertension, diabetes, outpatient radiotherapy/chemotherapy for malignant tumors, dialysis for uremia, and anti-rejection treatment aft…

Cost
No cost at all. You can complete the cross-regional medical registration once, right from …
Benefit
According to official documents from the National Healthcare Security Administration, this…

Follow the intervals recommended by your doctor for follow‑up visits, and record every measurement in the same notebook.

Chronic conditions require trends over time, rather than a single reading. Home blood-pressure measurement alone did not clearly lower pressure in the…

Cost
Each checkup costs anywhere from a few dozen to several hundred yuan. A trip to the hospit…
Benefit
An individual-participant meta-analysis combined 7,138 participants in 15 hypertension ran…

Don’t stop proper treatment to try folk remedies or supplements

In observational cancer data, people using alternative treatment instead of conventional treatment had 2.5 times the mortality hazard. People using co…

Cost
No cost at all; you even save money you’d otherwise spend on supplements. It takes no extr…
Benefit
Two US cancer-registry studies concerned nonmetastatic, potentially treatable breast, pros…

For patients with stable chronic conditions, community clinics can issue up to 12 weeks’ worth of medication at one time

Individuals whose conditions remain stable and whose medication regimens have not changed can obtain enough medication for 12 weeks from a community h…

Cost
There is no cost involved. Simply ask at your local community health center whether they c…
Benefit
Patients no longer need to make monthly trips to larger hospitals just to obtain prescript…

Before signing up for a family doctor in your community, find out which services are covered by yibao and which you’ll have to pay for out of pocket

The standard package of basic services is covered by yibao as required. Any customized service packages must be paid for entirely by the patient. When…

Cost
There’s no cost involved. Asking a few questions before you sign up takes just a minute.
Benefit
The basic service package is paid for by yibao per regulations. Customized packages requir…

Get a dilated eye exam right after a diabetes diagnosis, then follow your doctor’s recommended schedule; check your feet once a year.

Diabetes can damage both the retina and feet, but there are almost no noticeable symptoms until the damage becomes severe enough to cause vision loss …

Cost
A single dilated eye exam costs anywhere from a few dozen to several hundred yuan. Foot ex…
Benefit
Retinal damage caused by diabetes is known as diabetic retinopathy, while damage to the fe…

Long‑term use of uric‑acid‑lowering drugs after a gout diagnosis to keep levels below 360 µmol/L

Gout requires lifelong use of uric‑acid‑lowering drugs to keep levels under 360 µmol/L; painkillers alone are insufficient. In a study where nurses he…

Cost
Allopurinol costs only a few to several tens of yuan per month. At first, blood uric‑acid …
Benefit
In a randomized controlled trial of 517 adults who had experienced gout attacks within the…

For individuals with a history of gout, avoid consuming large single-meal portions of meat and seafood during barbecues and banquets, and strictly limit alcohol

For individuals with prior gout attacks, consuming high-purine meals over a two-day period raises the odds of an acute recurrent gout attack nearly 5-…

Cost
Zero financial outlay. Simply order fewer skewers of meat and seafood dishes, and minimize…
Benefit
A 1-year prospective internet-based case-crossover study of 633 gout patients compared die…

If testing positive for Hepatitis B surface antigen (HBsAg), undergo liver ultrasound plus serum AFP screening every six months: initiate antiviral therapy upon physician evaluation and never discontinue medication autonomously

For individuals carrying chronic hepatitis B virus (HBV), biannual screening with liver ultrasound and alpha-fetoprotein (AFP) reduced liver cancer mo…

Cost
Low cost. Visit hepatology or infectious disease outpatient clinics twice a year for routi…
Benefit
In a randomized controlled trial in Shanghai involving 18,816 individuals aged 35–59 with …

For diagnosed COPD, demonstrate your inhaler technique to your doctor or pharmacist during follow-ups: complete pulmonary rehabilitation after hospitalization for an acute exacerbation

Only about 30% of inhaler users execute perfect technique; critical errors prevent the aerosol drug from reaching deep airways. Patients making critic…

Cost
Demonstrating inhaler technique during regular clinical follow-ups incurs zero extra fee b…
Benefit
The China Pulmonary Health (CPH) national survey of 50,991 adults aged >=20 undergoing spi…

Screen urine albumin-to-creatinine ratio (uACR) and serum creatinine annually if diagnosed with diabetes or hypertension: catch chronic kidney disease early

Only 10% of adults in China with chronic kidney disease (CKD) know they have it. Annual blood and urine testing in patients with diabetes and hyperten…

Cost
Low cost. Simply collect a random urine sample for uACR and have blood drawn for serum cre…
Benefit
The 6th China Chronic Disease and Risk Factor Surveillance (176,874 adults undergoing bloo…

After surgery and adjuvant chemotherapy for colon cancer, participate in a structured exercise program and maintain it for three years

For individuals completing surgery and adjuvant chemotherapy for colon cancer, participating in a 3-year structured, supervised exercise program reduc…

Cost
Low cost. Aerobic exercises like brisk walking cost nothing; clinical baseline fitness ass…
Benefit
The multicenter CHALLENGE randomized controlled trial conducted across 55 medical centers …