Impact of Covid-19 Confinement Measures on Chronic Diseases Managed in Primary Health Care.

Sabela Couso Viana, Bárbara Oliván Blázquez, Fátima Dios Quiroga, Ana Clavería Fontán, Beatriz González Álvarez, Magallon Botaya

Keywords: confinement, digital health, chronic disease, primary health care, covid-19.

To contain the spread of the first wave of the COVID-19 pandemic, home lockdown for 10 weeks was enforced in Spain. This confinement measure has had a direct impact on health care organisation, as well as on lifestyles and multiple social behaviours. These aspects may have influenced on the health of citizens, especially those with chronic pathologies.

Research questions:
Have patients with chronic diseases with prevalence higher than 5% and their clinical follow-up from Primary Care worsened after home closure?

Study design: Observational study with data extracted from the primary care electronic medical records of a Spanish Health Region (Aragon).
Period: Data was collected during 6 months before lockdown (14/09/19-14/03/20), during confinement (14/03/20-03/05/20) and 6 months (03/05/20-03/11/20) and 12 months (03/11/20-03/05/21) following confinement.
Participants and sample size: All patients over 16 years-old with at least one active episode of any diseases with prevalence higher than 5% and some clinical parameter to assess their follow-up from Family Physicians.
Variables: sex, age, copayment, episode (coded with International Classification of Primary Care) and their clinical parameters. Selected pathologies and clinical parameters were: Diabetes (glucose concentration(mg/dl), glycated haemoglobin(%); arterial hypertension (systolic blood pressure(mmHg), diastolic blood pressure(mmHg)), dyslipidaemias (total cholesterol(mg/dl), C-HDL(mg/dl), C-LDL(mg/dl), Triglycerides(mg/dl)); hypothyroidism (TSH(μU/mL) and free T4(μg/dL)); and chronic renal disease (creatinine(mg/dl)). BMI will also be checked before and after lockdown.
Analysis: Descriptive analysis and means comparison at pre-post lockdown with Wilcoxon or t-student test for repeated measures of clinical parameters.

A total of 732,585 patients were included, 54.1% were women, the mean age was 56.7 years (SD 18.6 years) and 67.17% (95%CI:67.06%-67.28%) of the sample had an income of less than 18,000 euros. Information of clinical parameters and conclusions will be presented at the congress.


Points for discussion: