China CDC Weekly | Experts’ Consensus on the Management of Respiratory Disease Syndemic

Experts’ Consensus on the Management of Respiratory Disease Syndemic

Weizhong Yang, Zhongjie Li, Ting Yang, and et al. 
China CDC Weekly, 2024, 6(8): 131-138. 
DOI: 10.46234/ccdcw2024.029

What is already known about this topic?

Multiple complex respiratory diseases are prone to co-occurrence, forming a syndemic. There is an urgent need for a comprehensive and robust management approach to effectively address these situations. 

What is added by this report?

This study, grounded in evidence-based methodology, revolves around the management of respiratory disease syndemic. A total of 7,085 relevant articles were retrieved and indexed up to December 2023. The synthesis involved a comprehensive review of guidelines, consensus statements, and recommendations pertaining to the management of respiratory diseases. Relevant evidence was consolidated, considering advancements in research and practices for the prevention and treatment of respiratory disease syndemic. Through three rounds of expert discussions, this consensus was formulated. A total of 15 recommendations were generated, covering 3 recommendations for Concept and Impact, 3 recommendations for Management Targets, 5 recommendations for Management Principles, and 4 recommendations for Management Strategies. 

What are the implications for public health practice?

It is hoped that expert consensus will promote broader advocacy and practical application of concepts and methods for the management of respiratory disease syndemic.

Results
Concept and Impact

Recommendation 1: A respiratory disease syndemic is characterized by the concurrent presence and interconnectedness of multiple respiratory diseases within a population.
Recommendation 2: It is essential to assess the impact of respiratory disease syndemics at both the individual and population levels.
Recommendation 3: The presence of respiratory disease syndemics adds complexity to diagnostic and treatment procedures, which can lead to increased demands for healthcare services and complicated medication regimens. This poses long-term challenges for communities.

Management Targets

Recommendation 4: The main goal of managing respiratory disease syndemics is to proactively reduce the incidence of new respiratory diseases.
Recommendation 5: Enhancing the overall health status and quality of life of populations with respiratory comorbidities is also a crucial objective in managing the syndemic of respiratory diseases.
Recommendation 6: Another crucial objective is to prevent deaths resulting from the syndemic of respiratory diseases.

Management Principles

Recommendation 7: It is essential to consistently evaluate the health status and efficacy of treatment methods among populations affected by respiratory disease syndemics. This is important for early detection, optimizing treatment strategies, and effectively managing concurrent chronic non-communicable and communicable respiratory diseases.
Recommendation 8: Surveillance plays a crucial role in the management of respiratory disease syndemics as it facilitates early detection and intervention.
Recommendation 9: Minimizing medication is a fundamental principle in the management of respiratory disease syndemics.
Recommendation 10: It is essential to establish an interdisciplinary team consisting of experts in infectious diseases, respiratory medicine, immunology, public health, and related fields. This team will play a critical role in the prevention, diagnosis, control, treatment, and rehabilitation of respiratory disease syndemics.
Recommendation 11: Effective management of respiratory disease syndemics necessitates strong collaboration among hospitals, communities, families, and patients.

Management Strategies

Recommendation 12: In the management of respiratory disease syndemics, it is essential to implement classification management based on the types of syndemics.
Recommendation 13: The management of co-infection of multiple acute respiratory infectious diseases should prioritize personalized treatment, disease transmission control, and disease prevention.
Recommendation 14: The management of comorbidity in patients with multiple chronic respiratory diseases should prioritize comprehensive pulmonary rehabilitation services and the prevention of infectious diseases.
Recommendation 15: The management of acute respiratory infections in patients with chronic respiratory diseases should prioritize infection control, prevention of disease worsening, mortality, and new infections. Additionally, comprehensive rehabilitation services should be provided to these patients.