Amgen Canada Inc, Mississauga, ON, Canada.
Department of Medicine, Division of Rheumatology, Laval University and CHU de Québec Research Centre, Quebec City, QC, Canada.
Arch Osteoporos. 2022 Aug 3;17(1):110. doi: 10.1007/s11657-022-01132-7.
PURPOSE/INTRODUCTION: The objective of this study was to describe osteoporosis-related care patterns during the coronavirus disease 2019 (COVID-19) pandemic in Alberta, Canada, relative to the 3-year preceding.
A repeated cross-sectional study design encompassing 3-month periods of continuous administrative health data between March 15, 2017, and September 14, 2020, described osteoporosis-related healthcare resource utilization (HCRU) and treatment patterns. Outcomes included patients with osteoporosis-related healthcare encounters, physician visits, diagnostic and laboratory test volumes, and treatment initiations and disruptions. The percent change between outcomes was calculated, averaged across the control periods (2017-2019), relative to the COVID-19 periods (2020).
Relative to the average control March to June period, all HCRU declined during the corresponding COVID-19 period. There was a reduction of 14% in patients with osteoporosis healthcare encounters, 13% in general practitioner visits, 9% in specialist practitioner visits, 47% in bone mineral density tests, and 13% in vitamin D tests. Treatment initiations declined 43%, 26%, and 35% for oral bisphosphonates, intravenous bisphosphonates, and denosumab, respectively. Slight increases were observed in the proportion of patients with treatment disruptions. In the subsequent June to September period, HCRU either returned to or surpassed pre-pandemic levels, when including telehealth visits accounting for 33-45% of healthcare encounters during the COVID periods. Oral bisphosphonate treatment initiations remained lower than pre-pandemic levels.
This study demonstrates the COVID-19 pandemic and corresponding public health lockdowns further heightened the "crisis" around the known gap in osteoporosis care and altered the provision of care (e.g., use of telehealth and initiation of treatment). Osteoporosis has a known substantial care and management disparity, which has been classified as a crisis. The COVID-19 pandemic created additional burden on osteoporosis patient care with healthcare encounters, physician visits, diagnostic and laboratory tests, and treatment initiations all declining during the initial pandemic period, relative to previous years.
目的/引言：本研究的目的是描述 2019 年冠状病毒病（COVID-19）大流行期间加拿大艾伯塔省与之前 3 年相关的骨质疏松症护理模式。
本研究采用重复横断面研究设计，涵盖 2017 年 3 月 15 日至 2020 年 9 月 14 日期间的连续 3 个月行政健康数据，描述了骨质疏松症相关的医疗保健资源利用（HCRU）和治疗模式。结果包括骨质疏松症相关医疗保健接触、医生就诊、诊断和实验室检查量以及治疗开始和中断的患者。计算结果在控制期（2017-2019 年）的平均值相对于 COVID-19 期（2020 年）的百分比变化。
与平均对照的 3 月至 6 月期间相比，所有 HCRU 在相应的 COVID-19 期间均下降。骨质疏松症医疗保健接触患者减少 14%，全科医生就诊减少 13%，专科医生就诊减少 9%，骨密度检查减少 47%，维生素 D 检查减少 13%。口服双膦酸盐、静脉双膦酸盐和地舒单抗的治疗起始分别下降 43%、26%和 35%。治疗中断的患者比例略有增加。在随后的 6 月至 9 月期间，HCRU 要么恢复到或超过大流行前的水平，包括在 COVID 期间占医疗保健接触的 33-45%的远程医疗访问。口服双膦酸盐治疗的开始仍然低于大流行前的水平。
本研究表明，COVID-19 大流行和相应的公共卫生封锁进一步加剧了骨质疏松症护理方面已知差距的“危机”，并改变了护理的提供方式（例如，使用远程医疗和开始治疗）。骨质疏松症存在已知的大量护理和管理差距，已被归类为危机。COVID-19 大流行给骨质疏松症患者的护理带来了额外的负担，与前几年相比，在大流行初期，医疗保健接触、医生就诊、诊断和实验室检查以及治疗开始都有所减少。
