Managing noncommunicable diseases during the COVID-19 pandemic in Brazil: findings from the PAMPA cohort

Abstract

The objective was to identify the impact of social distance in the management of noncommunicable diseases (NCD) in the adult population from the state of Rio Grande do Sul, southern Brazil. This is an ambispective, population-based cohort study. Descriptive analysis and Poisson regression models were used and the results were reported as prevalence ratio and 95% confidence intervals. From a total of 1,288 participants, 43.1% needed medical care and 28.5% reported impaired management of NCDs during social distance. Female sex, age between 18 and 30 years old, living in the Serra region (central region of the state), people with depression and multimorbidity were more likely to have impaired management of NCDs. Being physically active reduced the probability of having impaired management of NCD by 15%. Reduced monthly income was associated with the difficulty in accessing prescription medicine and avoidance of seeking in-person medical assistance. Depression was associated with difficulties in accessing medications, while avoidance of seeking in-person medical assistance was more likely for people with multimorbidity, arthritis/arthrosis/fibromyalgia, heart disease, and high cholesterol.

First and second COVID-19 waves in Brazil: A cross-sectional study of patients’ characteristics related to hospitalization and in-hospital mortality

“…Furthermore, a study in the southern region of Brazil during the pandemic showed an association of multimorbidity with a greater chance of impaired management of chronic diseases. The study also related a reduction in access to medication and the search for face-to-face care among low-income people [48] .…”

What Was the Impact of COVID-19 Pandemic on Low Back Pain? Data from the PAMPA Cohort, Brazil.

“…People with chronic diseases are instructed to stay home, and are probably more likely to adhere to social distancing measures, since they are in the high-risk group for COVID-19. Also, people with chronic diseases are less likely to seek in-person healthcare during pandemic [31], which can contribute to increase pain levels in this population. These factors, as well as the consequent inability to keep on their usual routine might explain this association.…”

Recognizing the roles of primary health care in addressing non-communicable diseases in low- and middle-income countries: Lesson from COVID-19, implications for the future

“…As private transport is accessible only to the wealthier groups in many of these countries [ 7 , 8 ], these restrictions disrupted visits to health facilities and/or seeking health care for acute care and essential services related to NCDs. Several studies from LMICs also revealed severe disruption of health services for PLWNCDs, and consequently, the need for alternative delivery methods to face-to-face consultations [ 9 - 11 ]. Moreover, fear of contracting COVID-19 while seeking treatment also jeopardized their access to care [ 12 ].…”

“…Emerging evidence from LMICs also shows that PLWNCDs, particularly from marginalized populations, experience myriad challenges in accessing health services, and procuring medication for pre-existing conditions, missed follow-up visits, and experienced worsening of their pre-existing conditions [ 4 ]. The lockdown measures also aggravated risk factors for NCDs such as a sedentary lifestyle, unhealthy diet/less access to nutritional foods as well as increased smoking, alcohol and tobacco use [ 1 , 11 ].…”