Who this service is for
This follow-up consultation for chronic diseases is indicated for adults with stable and well-controlled conditions, including:
- High blood pressure — review, medication adjustment, and request for follow-up tests
- Type 2 diabetes — follow-up of glycemic control, medication review, and request for glycated hemoglobin and other tests
- Hypothyroidism — review and adjustment of levothyroxine based on TSH and free T4 tests
- Dyslipidemia — follow-up of the lipid profile and statin adjustment when indicated
- Chronic gastroesophageal reflux — follow-up and treatment renewal
- Stable asthma — review of the treatment plan and adjustment of inhaled medication
- Stable COPD — follow-up and review of the treatment plan
- Anxiety and depression under stable treatment — follow-up and medication renewal when indicated
- Chronic migraine — review of the preventive treatment plan
- Stable arthritis and rheumatologic conditions — follow-up and treatment renewal
- Other stable chronic conditions that require regular clinical follow-up
This service is indicated for stable and well-controlled chronic conditions. If you have new symptoms, worsening of the condition, or suspicion of decompensation, schedule a general clinical consultation for a complete evaluation.
What is included in the consultation
Review of disease control
The doctor reviews the current status of control of the chronic condition — including recent symptoms, tolerance of the current medication, adherence to treatment, and impact on daily functioning.
Review of follow-up tests
Send the most recent tests before the consultation — glycated hemoglobin, fasting glucose, lipid profile, TSH, free T4, renal function, complete blood count, and others relevant to your condition. The doctor reviews the results in the full clinical context and explains what the values mean for disease control.
Medication adjustment — at the physician's discretion
Where clinically indicated after a complete evaluation, the doctor adjusts the doses or the medication and issues an updated electronic prescription with ICP-Brasil digital signature, valid at pharmacies throughout Brazil.
Request for follow-up tests
The doctor requests the indicated follow-up tests for the next consultation — based on the condition, the current medication, and previous results.
Lifestyle guidance
Diet, physical activity, weight control, smoking, and alcohol consumption have a direct impact on the control of practically all chronic diseases. The doctor provides guidance on lifestyle changes based on the individual profile.
Referral to a specialist — when indicated
When the condition requires specialized evaluation — cardiologist, endocrinologist, pulmonologist, rheumatologist — the doctor refers you with the complete clinical documentation.
High blood pressure — the most common chronic disease in Brazil
High blood pressure affects approximately 36% of Brazilian adults — more than 60 million people. It is the main risk factor for heart attack, stroke, and kidney failure in Brazil, and most people with hypertension do not have adequate blood pressure control.
Regular follow-up of hypertension by teleconsultation includes:
- Review of blood pressure readings taken at home — the doctor provides guidance on how to measure correctly and how often
- Symptom assessment — headache, dizziness, palpitations, blurred vision
- Review and adjustment of antihypertensive drugs — dose, medication combinations, tolerability, and side effects
- Request for follow-up tests — renal function, electrolytes, electrocardiogram when indicated
- Overall cardiovascular risk assessment — to guide blood pressure control targets
- Guidance on a sodium-restricted diet, physical activity, and weight control
Very high blood pressure with intense headache, blurred vision, chest pain, or difficulty breathing is a hypertensive emergency — call SAMU (192) immediately.
Type 2 diabetes — follow-up and control
Brazil has the fourth largest population of people with diabetes in the world — approximately 16 million people. Poorly controlled diabetes is the leading cause of acquired blindness, non-traumatic amputation, and dialysis in Brazil.
Diabetes follow-up by teleconsultation includes:
- Review of glycemic control — glycated hemoglobin, fasting and postprandial glucose, home capillary glucose
- Review and adjustment of antidiabetic medication — metformin, gliflozins, GLP-1 analogues, sulfonylureas, and others
- Assessment of complications — feet, vision, kidneys — with referral to a specialist when indicated
- Request for follow-up tests — glycated hemoglobin, renal function, microalbuminuria, lipid panel
- Guidance on diet, physical activity, and home glucose monitoring
Hypothyroidism — review and adjustment of levothyroxine
Hypothyroidism affects approximately 10% of Brazilian adults — with higher prevalence in women. Adjusting the levothyroxine dose is one of the simplest follow-up procedures and one that benefits most from teleconsultation — it requires only review of TSH and free T4 tests and dose adjustment when necessary.
Hypothyroidism follow-up by teleconsultation includes:
- Review of symptoms — fatigue, weight gain, hair loss, constipation, cold intolerance
- Review of TSH and free T4 tests — with levothyroxine dose adjustment when indicated
- Guidance on the correct time to take levothyroxine and interactions with food and other medications
- Request for follow-up tests — TSH and free T4
Chronic diseases in Brazil — the follow-up problem
In Brazil, chronic disease follow-up faces specific challenges that make teleconsultation especially valuable:
Through SUS
Return consultations for chronic diseases in SUS are scarce — in many municipalities the interval between consultations is six months or more, which is inadequate for conditions that require more frequent follow-up. Access to specialists through SUS has waiting lists of months to years.
Through health plans
Many health plans cover return consultations but with significant bureaucracy — prior authorization, list of accredited doctors, delayed scheduling. Private teleconsultation may be faster and more accessible than the supplementary health system for routine chronic disease consultations.
For expats and foreigners
For foreigners living in Brazil with chronic conditions diagnosed in another country — diabetes controlled with medications with different names, hypertension treated with antihypertensives not available in Brazil — the follow-up consultation includes adapting the treatment to the medications available in the Brazilian market and the local health system.
Chronic disease follow-up for foreigners and expats in Brazil
For foreigners and expats living in Brazil with chronic conditions, the challenges are specific:
- Medications with different names — the same molecule may have completely different brand names in Brazil. The doctor identifies the equivalent available in the Brazilian market for each medication
- Medications not registered with ANVISA — some medications common in other countries are not registered with ANVISA and are not available in Brazil. The doctor advises on the available alternatives
- Different laboratory reference values — the reference values for glucose, cholesterol, TSH, and other tests may vary between countries. The doctor interprets the results based on Brazilian and international criteria
- Care in English — for foreigners who prefer to discuss the follow-up of chronic conditions in their own language, care is available in English and Spanish
