Managing multiple long-term conditions or multimorbidity across COVID-19 pandemic: a longitudinal qualitative study from India

Abstract

Objectives While many studies have documented adverse impact of multiple chronic conditions or multimorbidity on COVID-19 outcomes in patients, there is scarcity of report on how physicians managed these patients. We investigated the experiences and challenges of clinicians in managing patients with multimorbidity throughout the COVID-19 pandemic in Odisha state, India. Methods To understand the factors influencing illness management and the adaptive responses of physicians alongside the evolving pandemic, we followed a longitudinal qualitative study design. Twenty-three physicians comprising general practitioners, specialists, and intensivists, were telephonically interviewed in-depth. Saldana’s longitudinal qualitative data analysis method was employed for data analysis. Results COVID-19 pandemic initially diverted the attention of health systems, resulting in reduced care. With time, the physicians overcame fear, anxiety, and feelings of vulnerability to COVID-19 and started prioritising patients with multimorbidity for treatment and vaccination. All physicians recommended teleconsultation and digital health records to benefit chronic illness care during future public health crises Conclusion As the COVID-19 pandemic progressed, the importance of multiple long-term conditions was given increasingly importance by physicians underscoring the need to address them perennially. They became gradually resilient with the pandemic and paced with the changing health system to ensure care continuity for patients with multimorbidity.