Telemedicine-Based Multisystem Evaluation in a Young Woman With Chronic Respiratory, Gynecological, and Mental Health Conditions
Dr. Emmanuel Teyie
February 3, 2026
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Patient Voice
“For the first time, all my problems were discussed together.”
Patient feedback during teleconsultation
Background and Context
Patients with overlapping gynecological, respiratory, and mental health conditions often experience fragmented care and delayed intervention, particularly in low-resource settings.
Mary Health (DocMary) enables structured telemedicine consultations that support early risk stratification, integrated care planning, and patient-centered decision-making.
Patient Information
Attribute | Details |
|---|---|
Age | 30 years |
Sex | Female |
Date of consultation | January 2026 |
Consulting physician | Dr. Emmanuel Teyie |
Presenting Complaints
The patient presented with multiple chronic symptoms affecting different systems.
Intermittent cough with months-long duration
Chronic pelvic pain radiating to the lower extremities
Relevant Medical History
Gynecological History
The patient has a documented history of polycystic ovary syndrome, a uterine fibroid measuring approximately 2 cm, adenomyosis, and endometriosis.
Respiratory History
There is suspected bronchial asthma with features suggestive of sleep apnea.
Gastrointestinal History
The patient has a history of acid reflux and peptic ulcer disease, which is currently controlled.
Mental Health History
The patient has a known history of depression.
Psychosocial Assessment
PHQ-9 Screening Results
Measure | Result |
|---|---|
PHQ-9 score | 21 out of 27 |
Interpretation | Severe depressive disorder |
The patient reported anhedonia, low energy, impaired concentration, and emotional distress. Although not in an acute suicidal crisis, her history places her at elevated risk.
Clinical Assessment
Based on the telemedicine evaluation, the following clinical priorities were identified.
Severe major depressive disorder identified as high priority
Chronic pelvic pain secondary to endometriosis and adenomyosis
Polycystic ovary syndrome with possible metabolic and respiratory interaction
Chronic cough with differential diagnosis including allergic airway disease and cough-variant asthma
Management Plan
Investigations
Investigation | Purpose |
|---|---|
Full blood count | Evaluation for anemia |
HbA1c | Metabolic assessment |
Renal function tests | Baseline renal assessment |
Serum C-peptide | Metabolic evaluation |
Abdominal and pelvic ultrasound | Structural assessment |
Routine urinalysis | General screening |
Non-Pharmacological Management
Sleep hygiene reinforcement was advised along with continuation of psychotherapy.
Pharmacotherapy
Medication | Regimen |
|---|---|
Rabeprazole | 20 mg daily for 7 days |
Sertraline | 25 mg daily with low-dose initiation |
Azithromycin | 500 mg daily for 3 days |
Cetirizine | 10 mg nightly |
Management Approach
A multidisciplinary care pathway is planned, involving coordinated input from gynecology and psychiatry teams to address the patient’s gynecological pathology and severe depressive disorder in parallel with medical management.
The Impact: Integrated Care and Trust
The telemedicine consultation resulted in meaningful clinical and patient-centered outcomes.
An integrated multisystem care plan was established in a single consultation.
Early mental health intervention was initiated.
Diagnostic and follow-up pathways were clarified.
High patient satisfaction and confidence in care were reported.
Patient Satisfaction
Measure | Result |
|---|---|
Overall satisfaction | 5 out of 5 |
Would recommend telemedicine | Yes |
Growing Forward, Together
Telemedicine can function as a comprehensive clinical gateway for complex patients.
It enables earlier intervention for mental health risk.
It reduces fragmentation of care.
It improves patient engagement and continuity.
It supports efficient use of referral pathways.
