Monday, July 15, 2024

COVID-19: Healthcare Institute Finds No Demonstrable Effect of Paramedical Recovery Care

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COVID-19 has led the Dutch Healthcare Institute to conclude that first-line multidisciplinary paramedical recovery care for adults with post-COVID symptoms does not demonstrate better results than natural recovery without any treatment. This form of combination therapy, temporarily reimbursed since August 2020, will not be included in the basic healthcare package. However, the Ministry of Health, Welfare and Sport (VWS) has promised a transitional arrangement until the end of 2024, allowing current recipients to complete their treatment.

In July 2020, amidst the early COVID-19 pandemic’s uncertainty, the first wave of infections had just subsided. There were no vaccines available, and many patients continued to suffer from persistent post-COVID symptoms. In response, the then Minister of Health, Welfare and Sport conditionally approved first-line multidisciplinary paramedical recovery care for these patients.

COVID-19: Conditional Approval of Multidisciplinary Paramedical Treatment Extended Until 2025

This treatment could include occupational therapy, physiotherapy, exercise therapy, speech therapy, and dietetics. This care seemed promising, and scientific research was initiated to determine its effectiveness, a requirement for conditional approval. The initial approval period was set to expire on August 1, 2021, but was extended until January 2025.

The Healthcare Institute’s statutory duties require it to evaluate whether a treatment complies with “the state of science and practice,” determining its effectiveness before the end of the conditional admission. This assessment was based on a study led by Radboud University Medical Center, which found positive changes in participants who received the care, including improvements in physical functioning and quality of life.

However, a comparative analysis by researchers from VU, using data from the LongCOVID cohort of the RIVM, revealed that the health improvements in the treated group were similar to those who recovered naturally without the multidisciplinary paramedical recovery care. The study concluded that there is no evidence that this recovery care is more effective than natural recovery. Consequently, this care cannot be included in the basic healthcare package as it does not provide added value for post-COVID patients.

The current arrangement for reimbursing this care runs until June 30, 2024. Patients already receiving primary multidisciplinary paramedical recovery care by this date can continue their treatment for up to six months. The Minister for Medical Care has promised a transitional arrangement until January 1, 2025, allowing these patients to complete their care. After this date, reimbursement for this specific form of recovery care will cease. However, individual components such as occupational therapy, dietetics, and speech therapy will still be reimbursed under certain conditions, and physiotherapy and exercise therapy will only be reimbursed in specific situations. COVID care provided by general practitioners or hospitals will continue to be reimbursed.

COVID-19

COVID-19: Continued Research and Specialized Clinics Needed for Severe Post-COVID Symptoms

Despite the findings, a group of people with post-COVID still experiences severe limitations in daily life, including fatigue, lack of fitness, memory and concentration problems, dizziness, shortness of breath, and muscle pain. The Healthcare Institute encourages further research and supports the development of specialized post-COVID clinics in academic hospitals. This online portal is part of the Post-COVID Network Netherlands, which brings together patients, scientists, healthcare professionals, and social partners to coordinate research and patient care for post-COVID conditions.

The Dutch Healthcare Institute’s assessment has shown that first-line multidisciplinary paramedical recovery care for adults with post-COVID symptoms is no more effective than natural recovery. Initially approved under a temporary reimbursement plan since August 2020, this treatment will not be part of the basic healthcare package due to the lack of demonstrated added value. However, a transitional arrangement allows current recipients to complete their treatment until the end of 2024.

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This conditional approval was granted in response to the urgent need for effective post-COVID treatments during the early stages of the pandemic. The effectiveness of the care was assessed through a study led by Radboud University Medical Center, which noted improvements in physical functioning and quality of life among recipients. Nonetheless, a comparative analysis using data from the LongCOVID cohort found similar improvements in those who recovered naturally, leading to the conclusion that the paramedical recovery care does not offer additional benefits.

Patients currently receiving this care can continue their treatment until January 2025, but the specific reimbursement for this multidisciplinary approach will end. Individual components of paramedical care may still be reimbursed under certain conditions, and general COVID care by primary and hospital-based providers will continue.

The Healthcare Institute remains committed to addressing post-COVID challenges and is promoting the establishment of specialized clinics that combine care with ongoing scientific research. These efforts aim to find more effective treatments for the lingering effects of COVID-19.

Resource: Zorg instituut Nederland, June 28, 2024

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