Association between the Decrease in Medical Visit Frequency and Chronic Disease Worsening in the Early Stages of
Takeshi Takakubo1, Yuko Odagiri1, Masaki Machida1,2
1Department of Preventive Medicine and Public Health, Tokyo Medical University, Japan.
Insights
During the COVID-19 pandemic, many Japanese patients with chronic diseases reduced medical visits, increasing disease worsening risk. Factors like psychological distress and unemployment exacerbated these outcomes.
Area of Science:
- Public Health
- Epidemiology
- Health Services Research
Background:
- The COVID-19 pandemic significantly disrupted healthcare access and patient behaviors.
- Understanding changes in medical treatment for chronic diseases during pandemics is crucial for patient outcomes.
Purpose of the Study:
- To analyze shifts in medical treatment behaviors among Japanese chronic disease patients during the early COVID-19 pandemic.
- To identify factors contributing to the worsening of chronic diseases in this population.
Main Methods:
- A longitudinal panel survey of 2,400 participants recruited online.
- Evaluation of medical visit frequency, medication adherence, and telehealth use at baseline (May 2020) and follow-up (February 2021).
- Analysis of sociodemographic factors, psychological distress, and self-reported chronic disease worsening.
Main Results:
- 34% of participants initially decreased medical visit frequency, reducing to 16.5% at follow-up.
- Chronic disease worsening was reported by 5.1% at both baseline and follow-up.
- Disease worsening was linked to younger age, fewer medical visits, unemployment, smoking history, and psychological distress.
Conclusions:
- Reduced medical visits in early pandemic stages correlated with chronic disease worsening.
- Psychological distress, unemployment, and smoking history identified as key risk factors for adverse outcomes.
- Interventions targeting vulnerable populations are needed during public health crises to maintain chronic disease management.
Abstract:
Objective This longitudinal study aimed to clarify the changes in the medical treatment behavior of Japanese patients with chronic diseases during the early phase of the coronavirus disease 2019 (COVID-19) pandemic and examine the factors associated with disease worsening. Methods Subjects with chronic diseases were selected from a panel survey that started at the beginning of the COVID-19 pandemic consists of 2,400 participants recruited via the Internet. Medical treatment behaviors (decrease in medical visit frequency, inability to take regular medications, and utilization of telephone/online medical care), psychological distress, and sociodemographic factors were evaluated at baseline (May 2020) and at the follow-up survey (February 2021). A worsening of chronic diseases was defined as those who answered "yes" to the question, "Has-the-condition-of-the-chronic-disease-worsened?". The factors related to the worsening of chronic diseases at follow-up were examined. Results A total of 514 participants (mean age 61.6±12.9 years) were analyzed. The percentage of participants who reported decreasing medical visit frequency was 34% at the baseline and 16.5% at follow-up, and those who reported a worsening of chronic diseases was 5.1% and 5.1%, respectively. A worsening of chronic diseases at follow-up was significantly associated with a younger age, a decreased frequency of medical visits, unemployment, a history of smoking, and psychological distress. Conclusions A decreased frequency of medical visits was observed among one-third of the participants with chronic disease in the early stage of the pandemic, and it reduced by half at follow-up. In the early stages of an emerging infectious disease pandemic, decreased regular hospital/clinic visits can lead to a worsening of chronic diseases. Those who had psychological distress, unemployment, and a history of smoking were vulnerable to a worsening chronic disease.
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