COVID-19’s impact on primary care and related mitigation strategies: A scoping review.

John Broughan, Jayleigh Lim, Des Crowley, Brendan O’ Kelly, Ronan Fawsitt, Mary-Carmel Burke, Geoff Mccombe, John S Lambert, Walter Cullen

Keywords: COVID-19, pandemic, primary care, telemedicine, public health

There is limited evidence documenting COVID-19’s impact on primary care. This is concerning because primary care is where most patients with COVID-19 infection and/or concerns are likely to be treated, and where the pandemic’s long-term consequences will be managed.

Research questions:
How has COVID-19 impacted primary care and what strategies mitigate these impacts?

This study used a six-stage scoping review framework developed by Arksey and O'Malley (2005). The search process was guided by the Joanna Briggs Institute three-step search strategy and involved searching the PubMed, Embase, Scopus, CINAHL Plus, and Cochrane library databases. The review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Review. A thematic analysis approach proposed by Braun and Clarke was used to interpret the findings.

Thirty-two studies from 18 countries and six continents were included, 13 reported original research, three were reviews, and 16 were case reports reporting healthcare systems’ experiences of dealing with the pandemic. Themes concerned (a) the COVID-19 pandemic’s impact on primary care service provision (reduced capacity of/access to care, quality of care) and patients (poorer outcomes in comorbid patients, poorer mental health outcomes), (b) the impact of the rapid transition to telemedicine due to COVID-19 on primary care (ensuring care continuity, reduced healthcare opportunities), and (c) strategies to mitigate the impact of COVID-19 on primary care (infection prevention and control measures, alternatives/modifications to traditional service delivery or workflow, government policy responses, and education).

The COVID-19 pandemic has considerably impacted on primary care and various strategies to mitigate this impact have been described. Future research examining the pandemic’s ongoing impacts on primary care, as well as strategies to mitigate these impacts, is a priority.

Points for discussion:
Primary care’s role during the COVID-19 pandemic.

The themes that emerged.

The COVID-19 pandemic’s evolution and the need for ongoing investigation of its impact on primary care.