Answer

Acute Cases Versus Chronic Cases in Primary Care

Disease occurrence can be classified as either acute or chronic, based on the duration of illness. This categorization is particularly important because it helps in informing the patient management approaches as well as the formulation of possible diagnoses pending confirmatory investigations and tests (Finley et al., 2018).

In my opinion, acute cases, in general, can be described as cases that have occurred in the recent two to four weeks. Chronic cases, on the other hand, are cases that have been in existence or indolent for periods longer than four weeks. This is important in primary care as it helps healthcare service providers to effectively manage patients.

How do acute cases differ from chronic cases in primary care?

There are several parameters that I think can be used to differentiate acute cases versus chronic cases in primary care including:

• The onset of disease: This is the basic form of categorization between acute and chronic cases in primary care. Patients with acute cases will report to the primary care physician with new complaints of symptoms that were previously non-existent often under two to four weeks’ duration. In my experience, chronic cases on the other hand are often reported as long-standing complaints that have been experienced by a patient for extended periods with minimal interference to the normal quality of life.
• The severity of symptoms: Acute and chronic cases often differ on the level of severity of the reported symptoms. Based on my clinical experience, acute cases often present with very severe signs and symptoms that cannot be ignored by the patients including severe pain and loss of function of the respective tissue. Chronic cases, on the other hand, present with mild symptoms that are often tolerable by the patient. This does not always mean that chronic cases are negligible but a majority of the cases are tolerated by the patients well and they only seek medical attention when the symptoms worsen.
• Prognosis: Clinical studies have established that the overall prognosis of acute versus chronic diseases score differently. In most of the cases that I have observed, acute cases are associated with poor prognosis that can lead to loss of lives in the event of delayed medical intervention. Examples of such acute cases associated with poor prognosis include appendicitis or a ruptured ectopic pregnancy that quickly progresses to severe disease states and eventual loss of lives. Chronic cases on the other hand tend to record better overall prognosis for a patient. This is largely because most of such cases are indolent and do not rapidly worsen a patient’s health. The patients I interact with have common chronic cases ranging from osteoarthritis or properly managed hypertension and they are often very stable and will continue living as they manage their disease conditions.
• Likelihood of malignancy: Acute cases are often linked to malignant processes in the body given the rapidity of the progression of symptoms. This is a common occurrence in primary care that I can personally relate to. The same phenomenon is seen in acute cases such as acute leukemia that rapidly leads to wastage and loss of lives (Abelson et al., 2018). Chronic cases on the other hand are often associated with benign conditions that are not as aggressive. A good example is uterine fibroids in women that are often asymptomatic and slowly grow later causing pressure symptoms.
• Management of urgency: Acute cases often necessitate urgent management if a patient’s life is to be saved. Acute cases are in most cases life-threatening and thus require urgent medical attention. Chronic cases on the other hand are tolerable and thus the management is not an emergency situation.

Conclusion

I believe that primary care physicians or any other healthcare workers in primary care need to triage patients correctly so that those who require urgent care get prioritized over those who are stable. The knowledge of acute and chronic cases is thus an essential part of patient management that should be adopted as part of mainstay practice.

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References

Abelson, S., Collord, G., Ng, S. W., Weissbrod, O., Cohen, N. M., Niemeyer, E., … & Shlush, L. I. (2018). Prediction of acute myeloid leukaemia risk in healthy individuals. Nature, 559(7714), 400-404.

Finley, C. R., Chan, D. S., Garrison, S., Korownyk, C., Kolber, M. R., Campbell, S., … & Allan, G. M. (2018). What are the most common conditions in primary care?: Systematic review. Canadian Family Physician, 64(11), 832-840.