"Decline and uneven recovery from 7 common long-term conditions managed in the Catalan primary care after two pandemic years : an observational retrospective population-based study using primary care electronic health records"
Mora, Núria (Institut Català de la Salut)
Fina, Francesc (Institut Català de la Salut)
Méndez-Boo, Leonardo (Institut Català de la Salut)
Cantenys, Roser (Institut Català de la Salut)
Benitez-Camps, Mencia (Institut Català de la Salut)
Moreno, Nemesio (Institut Català de la Salut)
Balló, Elisabet (Institut Català de la Salut)
Hermosilla, Eduardo (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Fàbregas, Mireia (Institut Català de la Salut)
Guiriguet, Carolina (Institut Català de la Salut)
Cos Claramunt, Francesc Xavier (Universitat Autònoma de Barcelona)
Rodoreda, Sara (Institut Català de la Salut)
Mas, Ariadna (Institut Català de la Salut)
Lejardi, Yolanda (Institut Català de la Salut)
Coma, Ermengol (Institut Català de la Salut)
Medina, Manuel (Institut Català de la Salut)

Fecha:	2023
Resumen:	The incidence of chronic diseases during the COVID-19 pandemic has drastically been reduced worldwide due to disruptions in healthcare systems. The aim of our study is to analyse the trends in the incidence of 7 commonly managed primary care chronic diseases during the last 2 years of the COVID-19 pandemic in Catalonia. We performed an observational retrospective population-based study using data from primary care electronic health records from January 2018 to August 2022 (5. 1 million people older than 14 years). We divided the study period into two: a pre-pandemic period (before 14 March 2020) and a pandemic period. We performed a segmented regression analysis of daily incidence rates per 100,000 inhabitants of 7 chronic diseases: type 2 diabetes mellitus (T2DM), asthma, chronic obstructive pulmonary disease (COPD), ischemic heart disease (IHD), heart failure (HF), hypertension and hypercholesterolemia. In addition, we compared annual incidence between pandemic years (2020, 2021 and 2022) and 2019. Associated incidence rate ratios (IRR) were also calculated. Finally, we estimated the number of expected diagnoses during the pandemic period using data from 2019 and we compared it with the observed data. We analysed 740,820 new chronic diseases' diagnoses. Daily incidence rates of all 7 chronic diseases were drastically interrupted on 14 March 2020, and a general upward trend was observed during the following months. Reductions in 2020 were around 30% for all conditions except COPD which had greater reductions (IRR: 0. 58 [95% CI: 0. 57 to 0. 6]) and HF with lesser drops (IRR: 0. 86 [95% CI: 0. 84 to 0. 88]). Some of the chronic conditions have returned to pre-pandemic diagnosis levels, except asthma, COPD and IHD. The return to pre-pandemic diagnosis levels compensated for the drops in 2020 for T2DM and HF, but not for hypertension which presented an incomplete recovery. We also observed an excess of hypercholesterolemia diagnoses of 8. 5% (95%CI: 1. 81% to 16. 15%). Although primary care has recovered the pre-pandemic diagnosis levels for some chronic diseases, there are still missing diagnoses of asthma, COPD and IHD that should be addressed. The online version contains supplementary material available at 10. 1186/s12875-022-01935-0.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	COVID-19 ; Electronic health records ; Chronic diseases ; Primary care ; Incidence
Publicado en:	BMC Primary Care, Vol. 24 (january 2023) , ISSN 2731-4553

DOI: 10.1186/s12875-022-01935-0
PMID: 36641483

11 p, 3.1 MB

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