Maehl Nathalie, Bleckwenn Markus, Riedel-Heller Steffi G, Mehlhorn Sebastian, Lippmann Stefan, Deutsch Tobias, Schrimpf Anne
Department of General Practice, Faculty of Medicine, Leipzig University, Leipzig, Germany.
Institute of Social Medicine, Occupational Health and Public Health (ISAP), Leipzig University, Leipzig, Germany.
Front Med (Lausanne). 2021 Dec 15;8:760265. doi: 10.3389/fmed.2021.760265. eCollection 2021.
The COVID-19 pandemic affected regular health care for patients with chronic diseases. However, the impact of the pandemic on primary care for patients with coronary artery disease (CAD) who are enrolled in a structured disease management program (DMP) in Germany is not clear. We investigated whether the pandemic affected primary care and health outcomes of DMP-CAD patients ( = 750) by using a questionnaire assessing patients' utilization of medical care, CAD symptoms, as well as health behavior and mental health since March 2020. We found that out of concern about getting infected with COVID-19, 9.1% of the patients did not consult a medical practitioner despite having CAD symptoms. Perceived own influence on infection risk was lower and anxiety was higher in these patients compared to symptomatic CAD patients who consulted a physician. Among the patients who reported chest pain lasting longer than 30 min, one third did not consult a medical practitioner subsequently. These patients were generally more worried about COVID-19. Patients with at least one worsening CAD symptom (chest pain, dyspnea, perspiration, or nausea without apparent reason) since the pandemic showed more depressive symptoms, higher anxiety scores, and were less likely to consult a doctor despite having CAD symptoms out of fear of infection. Our results provide evidence that the majority of patients received sufficient medical care during the COVID-19 pandemic in Germany. However, one in ten patients could be considered particularly at risk for medical undersupply and adverse health outcomes. The perceived infection risk with COVID-19 might have facilitated the decision not to consult a medical doctor.
新冠疫情影响了慢性病患者的常规医疗保健。然而，疫情对德国参加结构化疾病管理项目（DMP）的冠状动脉疾病（CAD）患者的初级保健的影响尚不清楚。我们通过一份问卷调查了疫情是否影响了DMP-CAD患者（n = 750）的初级保健和健康结果，该问卷评估了自2020年3月以来患者的医疗保健利用情况、CAD症状以及健康行为和心理健康状况。我们发现，出于对感染新冠病毒的担忧，9.1%的患者尽管有CAD症状但未咨询医生。与咨询医生的有症状CAD患者相比，这些患者认为自己对感染风险的影响较低，焦虑程度较高。在报告胸痛持续超过30分钟的患者中，三分之一的患者随后未咨询医生。这些患者通常更担心新冠疫情。自疫情以来至少有一种CAD症状加重（胸痛、呼吸困难、出汗或无故恶心）的患者表现出更多的抑郁症状、更高的焦虑评分，并且尽管有CAD症状，但由于害怕感染而不太可能咨询医生。我们的结果表明，在德国的新冠疫情期间，大多数患者获得了足够的医疗保健。然而，十分之一的患者可能被认为特别有医疗供应不足和不良健康后果的风险。对感染新冠病毒的感知风险可能促使患者做出不咨询医生的决定。
