J Am Pharm Assoc (2003). 2022 May-Jun;62(3):834-839.e1. doi: 10.1016/j.japh.2021.11.013. Epub 2021 Nov 15.
The coronavirus disease 2019 (COVID-19) pandemic has drastically disrupted primary health care and pharmacy services, posing a challenge in people with chronic diseases who receive routine care. Currently, there exists limited literature on the indirect impact of the pandemic on chronic disease management, particularly related to accessibility to medications and health care resources.
To determine the prevalence of medical- and medication-related problems reported by people with chronic diseases during the pandemic. The secondary objective was to identify the barriers and contributing factors related to these medical- and medication-related problems.
The anonymous and voluntary, Web-based survey was filled out by interested adult respondents with chronic disease(s) across Michigan between September 1, 2020, and January 1, 2021. The primary outcome included self-reported medical- and medication-related problems during the pandemic. Secondary outcomes included potential risk factors for medical- and medication-related problems. Descriptive statistics was used to describe respondents' demographics, chronic disease characteristics, medication adherence, medical- and medication-related problems, and COVID-19-related factors. The multivariable Firth logistic regression was used to analyze correlations between potential risk factors associated with medical- and medication-related problems.
A total of 1103 respondents completed the survey and were included in the analysis. Approximately, 51% of respondents reported a medication-related problem with 19.6% reported problems obtaining medication(s) and 31.7% reported forgetting or not taking their medication(s). The top reason for problems obtaining medication(s) was doctor's office being closed for in-person visit(s). In addition, of all responses, more than half reported worsening symptoms of their chronic disease(s) during the pandemic especially with psychiatric disorders (79.5%) and inflammatory bowel disease (60%). Respondents with a significantly higher risk of medication-related problems included those who were younger, were female, and had psychiatric disorder(s), diabetes, arthritis, or lupus, and respondents with a significantly higher risk of medical-related problems included those with multiple chronic diseases, psychiatric disorder(s), and heart failure.
Understanding the consequences of the pandemic, such as medical- and medication-related problems, in this population is critical to improving health care accessibility and resources through potential outpatient pharmacy services during this and future pandemics.
2019 年冠状病毒病(COVID-19)大流行极大地扰乱了初级卫生保健和药房服务,给接受常规护理的慢性病患者带来了挑战。目前,关于大流行对慢性病管理的间接影响,特别是与药物和医疗保健资源的可及性相关的影响,文献有限。
确定在大流行期间报告患有慢性病的人所经历的与医疗和药物相关的问题的发生率。次要目标是确定与这些与医疗和药物相关的问题相关的障碍和促成因素。
2020 年 9 月 1 日至 2021 年 1 月 1 日期间,密歇根州的成年慢性病患者通过匿名自愿的网络调查进行了此项研究。主要结果包括大流行期间自我报告的与医疗和药物相关的问题。次要结果包括与医疗和药物相关的问题的潜在危险因素。采用描述性统计方法描述受访者的人口统计学、慢性病特征、药物依从性、与医疗和药物相关的问题以及与 COVID-19 相关的因素。采用多变量 Firth 逻辑回归分析与与医疗和药物相关的问题相关的潜在危险因素之间的相关性。
共有 1103 名受访者完成了调查并被纳入分析。约有 51%的受访者报告存在药物相关问题,19.6%的受访者报告存在获取药物的问题,31.7%的受访者报告忘记或未服用药物。获取药物的主要原因是医生办公室因面对面就诊而关闭。此外,在所有回复中,超过一半的受访者报告在大流行期间其慢性病症状恶化,尤其是精神障碍(79.5%)和炎症性肠病(60%)。药物相关问题风险显著增加的受访者包括年龄较小、女性以及患有精神障碍、糖尿病、关节炎或狼疮的受访者;医疗相关问题风险显著增加的受访者包括患有多种慢性病、精神障碍和心力衰竭的受访者。
了解此类人群中与大流行相关的后果,如与医疗和药物相关的问题,对于通过未来可能的门诊药房服务来改善大流行期间和未来的医疗保健可及性和资源至关重要。