Older adults with non-communicable chronic conditions and their health care access amid COVID-19 pandemic in Bangladesh: Findings from a cross-sectional study

Abstract

Background Burgeoning burden of non-communicable disease among older adults is one of the emerging public health problems. In the COVID-19 pandemic, health services in low- and middle-income countries, including Bangladesh, have been disrupted. This may have posed challenges for older adults with non-communicable chronic conditions in accessing essential health care services in the current pandemic. The present study aimed at exploring the challenges experienced by older Bangladeshi adults with non-communicable chronic conditions in receiving regular health care services during the COVID-19 pandemic. Materials and methods The study followed a cross-sectional design and was conducted among 1032 Bangladeshi older adults aged 60 years and above during October 2020 through telephone interviews. Self-reported information on nine non-communicable chronic conditions (osteoarthritis, hypertension, heart disease, stroke, hypercholesterolemia, diabetes, chronic respiratory diseases, chronic kidney disease, cancer) was collected. Participants were asked if they faced any difficulties in accessing medicine and receiving routine medical care for their medical conditions during the COVID-19 pandemic. The association between non-communicable chronic conditions and accessing medication and health care was analysed using binary logic regression model. Results Most of the participants aged 60–69 years (77.8%), male (65.5%), married (81.4%), had no formal schooling (58.3%) and resided in rural areas (73.9%). Although more than half of the participants (58.9%) reported having a single condition, nearly one-quarter (22.9%) had multimorbidity. About a quarter of the participants reported difficulties accessing medicine (23%) and receiving routine medical care (27%) during the pandemic, and this was significantly higher among those suffering from multimorbidity. In the adjusted analyses, participants with at least one condition (AOR: 1.95, 95% CI: 1.33–2.85) and with multimorbidity (AOR: 4.75, 95% CI: 3.17–7.10) had a higher likelihood of experiencing difficulties accessing medicine. Similarly, participants with at least one condition (AOR: 3.08, 95% CI: 2.11–4.89) and with multimorbidity (AOR: 6.34, 95% CI: 4.03–9.05) were significantly more likely to face difficulties receiving routine medical care during the COVID-19 pandemic. Conclusions Our study found that a sizeable proportion of the older adults had difficulties in accessing medicine and receiving routine medical care during the pandemic. The study findings highlight the need to develop an appropriate health care delivery pathway and strategies to maintain essential health services during any emergencies and beyond. We also argue the need to prioritise the health of older adults with non-communicable chronic conditions in the centre of any emergency response plan and policies of Bangladesh.

Factors influencing access and utilization of health services among older people during the COVID − 19 pandemic: a scoping review

“…Access to COVID-related services Acute COVID services [5,11,12] Supplementary oxygen services [5] ICU services [13] Access to non-COVID related services Homecare [14][15][16] Tele health [17][18][19][20][21][22][23][24][25][26][27][28] Routine/Outpatient health care [16,21,24,27,[29][30][31] Oral healthcare [24] Mental healthcare [11,12,19,29,30,[32][33][34][35][36][37][38] Medications [20] Palliative care services [13,23,39] Chronic healthcare services [40,41] Other primary healthcare services [42] Literacy and education Digital literacy [19,22,…”

Older adults with pre-existing noncommunicable conditions and their healthcare access amid COVID-19 pandemic: a cross-sectional study in eastern Nepal

“…23 Previous studies from India, Bangladesh and Hong Kong have reported difficulty accessing healthcare and/ or obtaining medication during the pandemic. [24][25][26] Although the previous literature from Nepal has suggested disruptions in health services amidst the pandemic, 20 it is unknown from patients' perspectives how much difficulty they experienced accessing healthcare amidst the pandemic. Framing the current study within the principle of vertical health equity, we aim to assess the relationships between pre-existing conditions and challenges in obtaining routine healthcare and medications during the COVID-19 pandemic among older adults in eastern Nepal.…”

Did COVID-19 impact osteoarthritis – clinical perspective?

“…The lockdown massively affected the healthcare system and influenced the methods of healthcare delivery. Social distancing and lockdown resulted in a significant decrease in physical activity level, loss of follow-up appointments with physicians and physical therapists (PTs), and delay or cancelation of surgical procedures [ 2 ▪ , 3 ▪ , 4 ].…”