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COVID-19 Lockdown in Patients with Chronic Diseases: A Cross-Sectional Study
Mathieu Boulin1, Amélie Cransac-Miet1, Marc Maynadié2
1Pharmacy Department, Dijon Bourgogne University Hospital, EPICAD LNC UMR 1231, 21000 Dijon, France.
Insights
The first COVID-19 lockdown saw high medication adherence (97%) in chronic disease patients, but 41% missed physician visits. Lifestyle changes included poor sleep and increased screen time, with 19% experiencing psychological distress.
Area of Science:
- Public Health
- Epidemiology
- Chronic Disease Management
Background:
- The initial COVID-19 lockdown significantly altered daily life for individuals worldwide.
- Patients with chronic conditions faced unique challenges regarding healthcare access and lifestyle management during this period.
Purpose of the Study:
- To assess the impact of the first COVID-19 lockdown on medication adherence, physician access, lifestyle behaviors, and mental health.
- To identify factors associated with unhealthy behaviors among housebound adults with chronic conditions during lockdown.
Main Methods:
- A cross-sectional phone survey was administered to 1274 adults with chronic conditions.
- Participants were recruited from eight regional chronic disease cohorts (CLEO CD study).
- Data collected included medication adherence, missed physician visits, lifestyle changes, and mental health status (Kessler-6 score).
Main Results:
- Medication adherence remained high at 97%.
- 41% of patients missed at least one scheduled physician visit.
- Common lifestyle changes included worsened sleep (71%), increased screen time (46%), and decreased physical activity (46%).
- 19% reported psychological distress (Kessler-6 score ≥ 5).
- Urban living, poorer self-reported mental health, and psychological distress were linked to unhealthy behaviors.
Conclusions:
- While medication adherence was strong, disruptions in healthcare access and lifestyle behaviors were prevalent during the lockdown.
- Patients in urban areas, those with psychological distress, or poor self-reported mental health require targeted support to mitigate unhealthy behaviors.
Abstract:
Background: We aimed to investigate the impact of the first COVID-19 lockdown on medication adherence, physician access, lifestyle behaviours, and mental health in patients with chronic conditions. Methods: A cross-sectional phone survey was conducted in 1274 housebound adults recruited from 8 regional chronic disease cohorts (CLEO CD study: NCT04390126). Results: Medication adherence was 97%; 305 (41%) patients declared that at least one scheduled visit with a physician was missed during the first lockdown. The main changes in lifestyle behaviours were deterioration in sleep time (duration and/or quality; 71%), increase in screen time (46%), and decrease in physical activity (46%). Nineteen percent experienced psychological distress (Kessler-6 score ≥ 5). An urban living place (OR, 1.76 vs. rural; 95% CI, 1.32−2.33; p = 10−4), worse self-reported mental health (OR, 1.62 vs. about the same or better; 95% CI, 1.17−2.25; p = 0.003), and a K6 score ≥ 5 (OR, 1.52 vs. <5; 95% CI, 1.05−2.21; p = 0.03) were independent factors associated with at least one unhealthy behaviour. Conclusions: Encouraging results were observed in terms of medication adherence. Caution is needed in chronic disease patients living in urban places as well as those presenting psychological distress and worse self-reported mental health to reduce unhealthy behaviours.
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