Morbidity trends in Hong Kong

David VK Chao 周偉強

HK Pract 2024;46:22-23

In order to provide an update on the disease pattern and changes in morbidity in Hong Kong primary care setting, a prospective practicebased survey has been conducted from March 2021 to February 2022 by the Department of Family Medicine and Primary Care of the University of Hong Kong and the Hong Kong College of Family Physicians supported by the University Grants Council Research Matching Grants Scheme and the Hong Kong College of Family Physicians. Thanks to the tremendous work and dedication of the research team, despite the study was conducted during the time when COVID-19 was still affecting Hong Kong, a total of 49 practising primary care doctors contributing 172 doctor-weeks resulting in 40984 health problems based on 26897 patient encounters have been obtained for analysis. In this update survey, the authors found that the most frequently recorded diagnoses were hypertension, hyperlipidaemia, vaccination, non-insulin dependent diabetes mellitus and upper respiratory tract infections. The systems with the most frequently presenting complaints were Endocrine/metabolic and cardiovascular systems. When compared with the 2007-08 survey, there has been a notable increase in the proportion of chronic conditions from 35.6% to 46.7%, psychological problems from 2.6% to 2.8%, and preventive care from 3.1% to 9.2%, with a high proportion of these encounters being COVID-19 vaccinations. This study provides an overview on the breadth of primary care morbidity in Hong Kong despite the COVID-19 outbreak and demonstrates that the burden of chronic diseases, mental health and preventive care is on the rise. Hence, a family-doctor led model of primary care with an integrated system approach with dedicated resources are urgently needed to better support primary care doctors to care for patients in the community. For more details, please refer to the original article entitled “Hong Kong Primary Care Morbidity Survey 2021-2022” in this issue of the Hong Kong Practitioner.

Also in this issue of the Journal, “A case of body dysmorphic disorder (BDD) with pathological skin-picking” has been published. BDD has been classified under obsessive-compulsive or related disorders. It has been reported to be more commonly encountered in general practice and dermatology practice than in psychiatric settings. It is recommended that when general practitioners and dermatologists encounter a patient with little objective signs of skin disease but with high suffering and co-morbid psychosocial complaints, BDD could be one of the differential diagnoses to explain the patient’s condition. Therefore, it is important to screen patients with skinpicking for BDD and to screen for skin-picking in BDD patients. A combination of skin treatment, psychotherapy and psychopharmacological treatment would be needed for managing BDD patients. The authors mentioned that as BDD generally runs a recurring and chronic course, ongoing treatment and supervision are usually warranted.

Despite the COVID-19 pandemic was over, tens of millions of people around the globe are still suffering from the long-term sequelae of previous COVID-19 infections in varying degrees, or long COVID. Long COVID patients are a very heterogeneous group with possible involvements of literally all organs and systems. Long COVID management calls for a multidisciplinary approach. As such, family doctors should play a key role in the overall holistic care of long COVID patients. In the article “Understanding long COVID: a family physician’s perspective”, the authors present a comprehensive review on the current knowledge about long COVID for sharing among primary care doctors.