Chronic Disease Management

Service Description

Our chronic disease management service provides personalised, ongoing care for patients with long-term medical conditions, including essential hypertension, diabetes mellitus, hyperlipidaemia (high cholesterol), asthma, and gout. Our doctors work closely with each patient to develop an individualised management plan tailored to their medical needs and lifestyle. Care may include regular health assessments, medication review and optimisation, blood pressure and blood test monitoring, lifestyle and dietary advice, asthma control assessment, gout management, and screening for complications. Our aim is to achieve good disease control, reduce the risk of complications, and support patients in maintaining their long-term health and quality of life.