COVID-19 Lockdown in Patients with Chronic Diseases: A Cross-Sectional Study

Abstract

Background: We aimed to investigate the impact of the first COVID-19 lockdown on medication adherence, physician access, lifestyle behaviours, and mental health in patients with chronic conditions. Methods: A cross-sectional phone survey was conducted in 1274 housebound adults recruited from 8 regional chronic disease cohorts (CLEO CD study: NCT04390126). Results: Medication adherence was 97%; 305 (41%) patients declared that at least one scheduled visit with a physician was missed during the first lockdown. The main changes in lifestyle behaviours were deterioration in sleep time (duration and/or quality; 71%), increase in screen time (46%), and decrease in physical activity (46%). Nineteen percent experienced psychological distress (Kessler-6 score ≥ 5). An urban living place (OR, 1.76 vs. rural; 95% CI, 1.32–2.33; p = 10−4), worse self-reported mental health (OR, 1.62 vs. about the same or better; 95% CI, 1.17–2.25; p = 0.003), and a K6 score ≥ 5 (OR, 1.52 vs. <5; 95% CI, 1.05–2.21; p = 0.03) were independent factors associated with at least one unhealthy behaviour. Conclusions: Encouraging results were observed in terms of medication adherence. Caution is needed in chronic disease patients living in urban places as well as those presenting psychological distress and worse self-reported mental health to reduce unhealthy behaviours.

Patient-Perceived Impact of the COVID-19 Pandemic on Medication Adherence and Access to Care for Long-Term Diseases: A Cross-Sectional Online Survey

“…The prevalence of patients who reported a change in their medication intake during the COVID-19 pandemic is significantly lower in our study when compared with studies conducted among long-term patients in the US [29,30] but similar to other studies conducted in Europe [31][32][33][34][35][36]. Older and highly educated individuals were less likely to see their medication intake impacted by the pandemic, which is consistent with other studies [29,37], while taking medication for the respiratory system increased, by over three times, both the odds of having more regular medication intake and of increasing the medication dosage.…”

“…The literature describes several reasons for modifying or discontinuing treatment, including fear of being infected by attending hospitals or doctor appointments, a lack of access to medications and a perceived risk of severe COVID-19 symptoms due to the immunosuppressive effect of some medications [4,40]. In addition, our results show that more than 30% of medication discontinuations or adjustments were conducted without discussion with a healthcare professional, which is higher than reported in two other studies [29,31]; the literature in this area is lacking and needs further attention.…”

Mobile Device Usage before and during the COVID-19 Pandemic among Rural and Urban Adults

“…In a recent COVID-19 study in France, increased screen time was the most prevalent unhealthy behavior observed, and urban-dwelling participants were nearly twice as likely to report increased unhealthy behaviors (such as screen time, but also increased alcohol intake, smoking, lower sleep quality, etc.) compared to rural participants [ 23 ].…”

Occupational outcomes of people with multiple sclerosis during the COVID-19 pandemic: a systematic review with meta-analysis

“…All studies were observational studies, being 45 (91.8%) crosssectional studies and 4 (8.2%) longitudinal studies (Table 1). Studies were done in Argentina (26), Australia (27)(28)(29), Chile (30), China (31,32), Cuba (32), Egypt (33), Kuwait (33), France (34), Iran (35)(36)(37)(38)(39)(40), Italy (41)(42)(43)(44)(45)(46)(47)(48), Montenegro (49), Poland (50, 51), Portugal (52), Serbia (53,54), Spain (31,32,55), Turkey (56)(57)(58), and the United States of America (47,(59)(60)(61)(62)(63)(64)(65)(66)(67)(68)(69). Most of the articles demonstrated to have reasonable methodological quality.…”