Medication management and adherence during the COVID-19 pandemic: Perspectives and experiences from low-and middle-income countries

Kretchy, Irene A.; Asiedu-Danso, Michelle; Kretchy, James-Paul

doi:10.1016/j.sapharm.2020.04.007

Cited by 225 publications

(232 citation statements)

References 28 publications

(2 reference statements)

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“…In an attempt to curb the spread of COVID-19, the Government of India announced a nationwide lockdown on 24th March 2020 by the PM [5]. This much needed step taken towards the containment of the virus has, to some extent, adversely affected the availability of routine health care facilities, supply of drugs, and medical equipment [6]. The limitation in access to health care facilities, drugs, and other resources, along with the known vulnerability to infection due to a compromised immune system, has left many with apprehension and increased stress levels [16].…”

Section: Discussionmentioning

confidence: 99%

“…In an attempt to mitigate the spread of the disease, an unprecedented practice of social distancing has been instituted across the nation [5]. Strict isolation measures, interruption in access to routine health care, compromised academic, and social activities are contemplated to instigate stress and anxiety among all, particularly those living with chronic illnesses, such as type 1 diabetes (T1D) [6].…”

Section: Introductionmentioning

confidence: 99%

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COVID-19 pandemic: a double trouble for Indian adolescents and young adults living with type 1 diabetes

Agarwal¹,

Harikar

Shukla³

et al. 2020

Int J Diabetes Dev Ctries

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Background Strict isolation measures and interrupted health care services during the COVID 19 pandemic are contemplated to instigate stress universally, particularly in those with chronic illnesses such as type 1 diabetes (T1D). Methods A cross-sectional, observational study was done to assess determinants of stress and its impact on glycemic control in adolescents and young adults (aged 12-24 years) living with T1D in India. An online, semi-structured survey including Perceived Stress Scale (PSS-10) was distributed and results were analyzed. Results A total of 89 participants (46 males, mean age 19.61 ± 3.8 years) with T1D completed the survey. Age (r = 0.325, p = 0.005) and HBA1C level within the preceding 3 months (r = 0.274, p = 0.036) correlated positively with PSS-10 scores. There was a statistically significant difference in PSS-10 score based on gender (t(70) = − 2.147; p = 0.035), education (F (4,67) = 4.34, p = 0.003), and occupation (F(3,68) = 4.50, p = .006). On multiple linear regression, gender, occupation, and HbA1C were the significant determinants of PSS-10 (F(3,55) = 12.01, p < 0.001, R 2 = 0.363). One-way ANOVA showed a significant impact of mean PSS-10 score on the glycemic control (F(2,69) = 3.813, p = 0.027). Conclusion An increased prevalence of stress was seen among Indian adolescents and young adults living with T1D. Female gender, salaried individuals, and pre-existing poorly controlled diabetes contributed to an increased risk of stress. Increased stress resulted in worsened glycemic control.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

COVID-19 pandemic: a double trouble for Indian adolescents and young adults living with type 1 diabetes

Agarwal¹,

Harikar

Shukla³

et al. 2020

Int J Diabetes Dev Ctries

View full text Add to dashboard Cite

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“…This finding was very much similar to the previous studies that reported the high prevalence of self-medication (including antimicrobials) since people could obtain any drugs from the pharmacies without prescription even in the distant areas of the country 18 . Moreover, during pandemic, people struggle to cope with constant news of the spread and effects of COVID-19 on news-media, social-media, internet without having adequate forms of social support and access to doctors as a result of lockdowns and self-isolation 8,19 . Most of the respondents (37.61%) took antibiotic as self-medication for fever during Covid19 outbreak, followed by throat pain (28.79%), dry cough (14.20%); whereas almost 16.77% respondents had no symptoms whatsoever.…”

Section: Discussionmentioning

confidence: 99%

Prevalence, Pattern and Impact of Self Medication of Anti-infective Agents During COVID-19 Outbreak in Dhaka City

Nasir

Talha

Chowdhury

et al. 2020

Preprint

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Background: The outbreak of coronavirus disease-2019 is putting a massive strain on vulnerable healthcare system in low and middle-income countries like Bangladesh. Inequitable access to healthcare is further widened by the socio-economic gap and sense of insecurity during this pandemic. Self-medication is a common practice in Bangladesh as it provides a low-cost alternative for people, which involves inappropriate and injudicious use of medicines to treat self-recognized symptoms by the people. During the outbreak of COVID-19 in Dhaka city, the tendency of taking medicines by own decision was thought to be increased alarmingly due to unusual distress, caused by high self-awareness of their health and buying capacity of medication. Objectives: To observe the prevalence, pattern, sources and impact of self-medication practice among the respondents with high socio-economic standings and education. Setting: Citizens living in Dhaka city, Bangladesh during COVID-19 outbreak from April 2020 to May 2020. Method: Cross sectional online survey conducted on 626 citizens without having background of medical knowledge or related to any healthcare services (doctors, nurses, pharmacist, medical students) by structured questionnaires during COVID-19 outbreak. Outcome measures: Frequency of self-medication, commonly used antimicrobial agents, symptoms causing self-medication, sources of inspiration, relation with COVID-19 test results, economic burden involved in self-medication during outbreak. Results: The prevalence of self-medication amid the outbreak of COVID-19 was 88.33% and only 179 (28.59%) took medication with doctors’ advice and remaining 447 (71.40%) respondents took the drugs as “self-medication” by other sources. The most frequently used anti-infective drugs during the outbreak were ivermectine (77.15%), azithromycin (54.15%), doxycycline (40.25%). The common symptoms were fever, throat pain, dry-cough and total 105 (16.77%) respondents took medications without having any symptoms. Almost 355 (85.33%) had taken medication without doing any test for COVID-19. The causes of self-medication as news of spread, effects and remedies in media channels, internet; mental stress of lockdown and isolation, insecurity and panic about scarcity of drug and healthcare support. Conclusion: High risks of developing antibiotic resistance, adverse drug reactions and financial loss was predictable with absence of strict regulatory enforcement to protect people and proper utilization resources during COVID-19 outbreak in Dhaka city.

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“…In an attempt to curb the spread of COVID-19, the Government of India announced a nation-wide lock-down on 23 rd March 2020 [10]. This much needed step taken towards the containment of the virus, has to some extent, adversely affected the availability of routine healthcare facilities, supply of drugs and medical equipment [18]. The limitation in access to health care facilities, drugs and other resources; along with the known vulnerability to infection due to a compromised immune system has left many with apprehension and increased stress levels [19].…”

Section: Discussionmentioning

confidence: 99%

“…In an attempt to mitigate the spread of the disease, an unprecedented practice of social distancing has been instituted across the nation [10]. Strict isolation measures, interruption in access to routine health care, compromised academic and social activities is contemplated to instigate stress and anxiety among all, particularly those living with chronic illnesses, such as Type 1 Diabetes (T1D) [11].…”

Section: Introductionmentioning

confidence: 99%

Perceived Stress Among Indian Children And Young Adults Living With Type 1 Diabetes During the COVID-19 Outbreak

Agarwal¹,

Harikar

Shukla³

et al. 2020

Preprint

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Background - Strict isolation measures and interrupted healthcare services during the COVID 19 pandemic are contemplated to instigate stress universally, particularly in those with chronic illnesses such as Type 1 Diabetes (T1D).Objective- To evaluate perceived stress towards COVID-19 among T1D individuals.Study Design - A cross-sectional, observational study. Participants - Adolescents and young adults (aged 10 - 25), living with T1D; and age, gender matched controls.Interventions - An online, semi-structured survey including Perceived Stress Scale. Outcomes - Determinants of stress and its impact on glycemic control.Results - A total of 97 cases (49 males; mean age 18.8 ± 4.5 years), diagnosed with T1D (mean diabetes duration 8.0 ± 5.0 years; mean HBA1C 8.1 ± 1.5%) completed the survey. Among cases, 53.6% reported moderate stress; 41.2% low stress and 5.2% severe stress. No significant difference was observed in the mean PSS score between the cases and controls. Cases with higher PSS scores tracked pandemic-related updates with significantly lesser frequency than those with lower scores (mean rank 78.75; p = 0.01). High PSS score was significantly associated with HbA1C over last 6 months (r 0.276; p = 0.015) and worsened glycemic control (mean rank 63.97 p = 0.012). Conclusion- An increased apprehension was seen regarding the acquisition of optimal diabetes management and care during the current infectious outbreak. Tele-medicine could emerge as an effective tool and a promising initiative to manage T1D patients during the pandemic.

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Medication management and adherence during the COVID-19 pandemic: Perspectives and experiences from low-and middle-income countries

Abstract: 3

Cited by 225 publications

References 28 publications

COVID-19 pandemic: a double trouble for Indian adolescents and young adults living with type 1 diabetes

COVID-19 pandemic: a double trouble for Indian adolescents and young adults living with type 1 diabetes

Prevalence, Pattern and Impact of Self Medication of Anti-infective Agents During COVID-19 Outbreak in Dhaka City

Perceived Stress Among Indian Children And Young Adults Living With Type 1 Diabetes During the COVID-19 Outbreak

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