The Impact of COVID-19 on Primary Care: A Scoping Review

Khalil-Khan, Alam; Khan, Moien AB

doi:10.7759/cureus.33241

Cited by 17 publications

(17 citation statements)

References 42 publications

(66 reference statements)

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“…The pragmatic responses to COVID-19 were largely driven within the medical com- Whilst some benefits from better data sharing and better IMS have been stepped back from, others have persisted. For example, the changes included a shift to remote consultation which has persisted [71,72].…”

Section: Discussionmentioning

confidence: 99%

Integrated Management Systems (IMS) to Support and Sustain Quality One Health Services: International Lessons from the COVID-19 Pandemic by the IMIA Primary Care Working Group

et al. 2023

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Objectives: One Health considers human, animal and environment health as a continuum. The COVID-19 pandemic started with the leap of a virus from animals to humans. Integrated management systems (IMS) should provide a coherent management framework, to meet reporting requirements and support care delivery. We report IMS deployment during, and retention post the COVID-19 pandemic, and exemplar One Health use cases. Methods: Six volunteer members of the International Medical Association’s (IMIA) Primary Care Working Group provided data about any IMS and One Health use to support the COVID-19 pandemic initiatives. We explored how IMS were: (1) Integrated with organisational strategy; (2) Utilised standardised processes, and (3) Met reporting requirements, including public health. Selected contributors provided Unified Modelling Language (UML) use case diagram for a One Health exemplar. Results: There was weak evidence of synergy between IMS and health system strategy to the COVID-19 pandemic. However, there were rapid pragmatic responses to COVID-19, not citing IMS. All health systems implemented IMS to link COVID test results, vaccine uptake and outcomes, particularly mortality and to provide patients access to test results and vaccination certification. Neither proportion of gross domestic product alone, nor vaccine uptake determined outcome. One Health exemplars demonstrated that animal, human and environmental specialists could collaborate. Conclusions: IMS use improved the pandemic response. However, IMS use was pragmatic rather than utilising an international standard, with some of their benefits lost post-pandemic. Health systems should incorporate IMS that enables One Health approaches as part of their post COVID-19 pandemic preparedness.

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Section: Discussionmentioning

confidence: 99%

Integrated Management Systems (IMS) to Support and Sustain Quality One Health Services: International Lessons from the COVID-19 Pandemic by the IMIA Primary Care Working Group

et al. 2023

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“…It is clear that telemedicine is here to stay (45). The potential negative consequences and risks are clearly recognised such as widening the gap between the advantaged and the disadvantaged (46), and the doubts about the quality of such consultations (47). However, the wider implementation has also shown good examples, where for instance, telemedicine helped the deprived gain access to care (48).…”

Section: Discussionmentioning

confidence: 99%

Lessons on integrated chronic care organisation of primary care during the COVID-19 pandemic: case study analyses in Cambodia, Slovenia, and Belgium

Danhieux,

Martens,

Chhim

et al. 2023

Preprint

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Background During the COVID-19 pandemic, people living with Noncommunicable diseases (NCDs) were at double risk: developing severe COVID-19 and developing complications from not having their chronic condition(s) well controlled. Primary Health Care (PHC) is paramount for integrated care of chronic diseases, but was severely restrained during the pandemic. Our aim was to examine how the organisation of PHC for chronic diseases was affected by the pandemic, and as such, shine a light on strengths, weaknesses, and opportunities in different types of health systems. Methods Semi-structured interviews with 69 participants were carried out in three countries with different primary health care systems: a developing health system in a lower middle-income country (Cambodia); a centrally steered health system in a high-income country (Slovenia); and a publicly funded highly privatised health-care health system in a high-income country (Belgium). Both PHC providers and macro-level stakeholders were interviewed by the international team. An inductive thematic analysis was performed. Results In all three countries the workload of the staff was high and shifted towards pandemic related tasks, affecting availability for chronic care. It also created space for innovations such as telemedicine. In general, recognition of the importance of PHC increased. But also considerable differences between the three countries’ health care systems have been uncovered. In Cambodia medicines are lacking but a strong civil servant ethos is present. In Slovenia strong leadership appeared to be an important strength, but flexibility of PHC workers was limited. This flexibility and entrepreneurship turned out to be valuable in Belgium, but there fragmentation of PHC was a barrier. Conclusions Moments of crisis and disruption lay bare the structural agility and gaps more clearly, as a magnifying glass. In Cambodia, there is a need to sustainable supply of medicines. In Slovenia, the shortage of general practitioners (GPs) needs attention. In Belgium, rethinking of the PHC practice organisation is needed. Our analyses provide the opportunity to analyze and build back stronger health care systems.

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“…58 Rules related to social distancing were still in place during fieldwork, and most medical practices in the United Kingdom significantly changed the way they operated during COVID. [59][60][61] Research has shown that among the most affected by those changes, in terms of health outcomes, were those with long-term conditions and multimorbidity. 62 Patients' perceptions and experiences were possibly influenced by those changes.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

‘It's a job to be done’. Managing polypharmacy at home: A qualitative interview study exploring the experiences of older people living with frailty

Previdoli,

Alldred,

Silcock

et al. 2024

Health Expectations

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IntroductionMany older people live with both multiple long‐term conditions and frailty; thus, they manage complex medicines regimens and are at heightened risk of the consequences of medicines errors. Research to enhance how people manage medicines has focused on adherence to regimens rather than on the wider skills necessary to safely manage medicines, and the older population living with frailty and managing multiple medicines at home has been under‐explored. This study, therefore, examines in depth how older people with mild to moderate frailty manage their polypharmacy regimens at home.MethodsBetween June 2021 and February 2022, 32 patients aged 65 years or older with mild or moderate frailty and taking five or more medicines were recruited from 10 medical practices in the North of England, United Kingdom, and the CARE 75+ research cohort. Semi‐structured interviews were conducted face to face, by telephone or online. The interviews were recorded, transcribed verbatim and analysed using reflexive thematic analysis.FindingsFive themes were developed: (1) Managing many medicines is a skilled job I didn't apply for; (2) Medicines keep me going, but what happened to my life?; (3) Managing medicines in an unclear system; (4) Support with medicines that makes my work easier; and (5) My medicines are familiar to me—there is nothing else I need (or want) to know.While navigating fragmented care, patients were expected to fit new medicines routines into their lives and keep on top of their medicines supply. Sometimes, they felt let down by a system that created new obstacles instead of supporting their complex daily work.ConclusionFrail older patients, who are at heightened risk of the impact of medicines errors, are expected to perform complex work to safely self‐manage multiple medicines at home. Such a workload needs to be acknowledged, and more needs to be done to prepare people in order to avoid harm from medicines.Patient and Public InvolvementAn older person managing multiple medicines at home was a core member of the research team. An advisory group of older patients and family members advised the study and was involved in the first stages of data analysis. This influenced how data were coded and themes shaped.

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The Impact of COVID-19 on Primary Care: A Scoping Review

Cited by 17 publications

References 42 publications

Integrated Management Systems (IMS) to Support and Sustain Quality One Health Services: International Lessons from the COVID-19 Pandemic by the IMIA Primary Care Working Group

Integrated Management Systems (IMS) to Support and Sustain Quality One Health Services: International Lessons from the COVID-19 Pandemic by the IMIA Primary Care Working Group

Lessons on integrated chronic care organisation of primary care during the COVID-19 pandemic: case study analyses in Cambodia, Slovenia, and Belgium

‘It's a job to be done’. Managing polypharmacy at home: A qualitative interview study exploring the experiences of older people living with frailty

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