The Effects of the Health System Response to the COVID-19 Pandemic on Chronic Disease Management: A Narrative Review

Abstract

Background Individuals with chronic conditions require ongoing disease management to reduce risks of adverse health outcomes. During the COVID-19 pandemic, health care for non-COVID-19 cases was affected due to the reallocation of resources towards urgent care for COVID-19 patients, resulting in inadequate ongoing care for chronic conditions. Methods A keyword search was conducted in PubMed, Google Scholar, Science Direct, and Scopus for English language articles published between January 2020 and January 2021. Findings During the COVID-19 pandemic, in-person care for individuals with chronic conditions have decreased due to government restriction of elective and non-urgent healthcare visits, greater instilled fear over potential COVID-19 exposure during in-person visits, and higher utilization rates of telemedicine compared to the pre-COVID-19 period. Potential benefits of a virtual-care framework during the pandemic include more effective routine disease monitoring, improved patient satisfaction, and increased treatment compliance and follow-up rates. However, more needs to be done to ensure timely and effective access to telemedicine, particularly for individuals with lower digital literacy. Capitation primary care models have been proposed as a more financially-robust approach during the COVID-19 pandemic than fee-for-service primary care models; however, the interplay between different primary models and the health outcomes is still poorly understood and warrants further investigation. Shortages of medication used to manage chronic conditions were also observed at the beginning of the COVID-19 pandemic due to global supply chain disruptions. Finally, patients with chronic conditions faced lifestyle disruptions due to the COVID-19 pandemic, specifically in physical activity, sleep, stress, and mental health, which need to be better addressed. Interpretation Overall, this review elucidates the disproportionately greater barriers to primary and specialty care that patients with chronic diseases face during the COVID-19 pandemic and emphasizes the urgent need for better chronic disease management strategies moving forward.

Covid-19 Pandemic-Related Stress and Coping Strategies Among Adults with Chronic Disease in Southwest Ethiopia

“…In addition to this, some studies have indicated that health care for chronic illness during COVID-19 outbreaks has been disrupted, which can be a constant source of stress. 11 , 29 On the other hand, this finding was lower than in a study conducted in India among patients undergoing hemodialysis, where the level of perceived stress was 97%. 30 The possible reason for this is that patients receiving hemodialysis may be threatened with more potential losses and changes in lifestyle compared with people with other chronic diseases.…”

“…16 Moreover, disruptions to ongoing health-care services for chronic disease patients will further worsen their health and perceived stress as a result of the shifting of health services to urgent COVID-19 patients. 11 Coping strategies refer to behavioral and cognitive efforts that help to reduce the influence of a stressful condition, 17 and are used when its demands exceed individual resources. 18 The relationship between stress and coping strategies has been a topic of previous studies, 19,20 because in critical situations stress affects many people, but individual responses vary according to their coping strategies.…”

“… 10 Patients with chronic disease face lifestyle disruptions due to the COVID-19 outbreaks, to their physical activity, sleep, stress, and mental health, which need to be better addressed. 11 The mental health and psychosocial consequences of the COVID-19 pandemic may be more severe among people with chronic illness. 12 Studies in Greece and northeast Ethiopia showed high prevalences of distress during COVID-19 outbreaks among patients with chronic disease, 13 , 14 and moderate perceived stress was reported from the USA among patients with chronic disease and disability.…”

“…16 Moreover, disruptions to ongoing health-care services for chronic disease patients will further worsen their health and perceived stress as a result of the shifting of health services to urgent COVID-19 patients. 11 …”

The Benefits of Telemedicine in Personalized Prevention of Cardiovascular Diseases (CVD): A Systematic Review

“…An increase in the use of telemedicine is expected to impact healthcare access quality, care costs, and education. Telemedicine technologies applied to home care have the potential to impact to present cardiac care models and explore the communication among experts, leading to have high-quality, more efficient, and less expensive care [ 42 , 43 ]. These models can function as a platform to provide primary care and management of critical care patients in a sophisticated manner [ 39 ].…”