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Cuevas Fernández FJ, Delgado Estévez JL, Hernández Lorenzo M, Segovia Martínez CM, Cabrera León A, Aguirre-Jaime A. [Diabetes control and visits to the family doctor during the COVID-19 pandemic: a multicenter study in primary care]. Aten Primaria 2024; 56:102815. [PMID: 38043174 PMCID: PMC10703598 DOI: 10.1016/j.aprim.2023.102815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 10/25/2023] [Accepted: 11/02/2023] [Indexed: 12/05/2023] Open
Abstract
OBJECTIVES To determine whether in patients with type 2 diabetes (DM2) the changes in their relationship with family doctors during the COVID-19 pandemic, in-person (iPC) and telematic (TC) consultations, were associated with control of their disease. DESIGN Multicentric study of retrospective follow-up. SETTING Seven health centers in Tenerife, Spain. PARTICIPANTS 3543 patients with DM2. MAIN MEASUREMENTS Sex, age, iPC, TC and DM2 control using glycosylated hemoglobin (A1c) during the period 2019-2021. Logistic regression models were fitted with DM2 control as an effect, and with the other measurements as independent variables. RESULTS 50% were women. 38% were less than 65 years old. A1c was measured in 84% of patients in 2019, 68% in 2020, and 77% in 2021. 58.4% had good control in 2019, 46.1% in 2020, and 50.3% in 2021. Median iPC were 7 in 2019, 4 in 2020 and 5 in 2021 (p<0.001). The OR(95%CI) of good control in 2019 were 1.04(1.04-1.05) per year of age and 1.03(1.01-1.04) for each iPC; In 2020 they were 1.04 (1.03-1.05) per year of age, 1.05 (1.04-1.07) for each iPC and 1.04 (1.02-1.07) for each TC; in 2021 they were 1.04 (1.04-1.05) per year of age, 1.05 (1.03-1.06) for each iPC and 1.02 (1.00-1.04) for each TC. CONCLUSIONS The control of patients with DM2 during the period 2019-2021 had a direct relationship with the change in the frequency of consultations at the health center, with differences depending on the type of consultation and the age of the patient.
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Affiliation(s)
- Francisco Javier Cuevas Fernández
- Gerencia de Atención primaria de Tenerife, Santa Cruz de Tenerife, España; Área de Medina Preventiva y Salud Pública, Universidad de La Laguna, Santa Cruz de Tenerife, España
| | - Juan Luis Delgado Estévez
- Gerencia de Atención primaria de Tenerife, Santa Cruz de Tenerife, España; Área de Medina Preventiva y Salud Pública, Universidad de La Laguna, Santa Cruz de Tenerife, España
| | | | - Cristóbal Manuel Segovia Martínez
- Gerencia de Atención primaria de Tenerife, Santa Cruz de Tenerife, España; Área de Medina Preventiva y Salud Pública, Universidad de La Laguna, Santa Cruz de Tenerife, España
| | - Antonio Cabrera León
- Área de Medina Preventiva y Salud Pública, Universidad de La Laguna, Santa Cruz de Tenerife, España; Unidad de Investigación de la Gerencia de Atención Primaria y del Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, España.
| | - Armando Aguirre-Jaime
- Servicio de Apoyo a la Investigación en Cuidados del Colegio de Enfermer@s de Santa Cruz de Tenerife, España
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Cuevas Fernández FJ, Gómez López OT, Dorta Espiñeira M, Farrais Villalba S, Cabrera de León A, Aguirre-Jaime A. [Follow-up of patients with type 2 diabetes during the COVID-19 pandemic: A multicentre study in Primary Care]. Semergen 2023; 49:102075. [PMID: 37639959 DOI: 10.1016/j.semerg.2023.102075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 07/12/2023] [Accepted: 07/21/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND The COVID-19 pandemic meant measures had to be taken that implied the neglect of patients with type 2 diabetes (T2D). OBJECTIVES to explore the impact of care discontinuity on patients with T2D in Primary Care (PC) centres, who did not have a specific action protocol for them, during 2020 and 2021. DESIGN Multicenter retrospective observational study. PARTICIPANTS Patients with T2D in Tenerife, Canary Islands, Spain. MAIN MEASUREMENTS Sex and age, follow-up variables of atherosclerotic vascular disease detection and control programme (pEVA), compliance with the control objectives and visits to the family practitioner and community nurse were extracted from their medical records. RESULTS 3,543 participants took part in the study, 1,772 (50%) women, 2,204 (62%) of whom were older than 65 years of age. The vast majority of registered activities and control objectives decreased in 2020, recovering in 2021 without reaching 2019 levels. In 2020, telephone consultations increased and in-person consultations decreased, a trend that remained unchanged in 2021 for telephone consultations. Women and those over 65 years of age presented higher frequentation, more activity records and achievement of control objectives in most of the parameters. CONCLUSIONS The pandemic caused an overload in the PCs that affected the care of patients with T2D, which has not returned to pre-pandemic levels. Young men are the target for prioritization of this care. Anti-pandemic measures have led to an increase in telephone consultations, a resource that should be strengthened.
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Affiliation(s)
- F J Cuevas Fernández
- Gerencia de Atención Primaria de Tenerife, Servicio Canario de la Salud, Santa Cruz de Tenerife, España; Área de Medina Preventiva y Salud Pública, Universidad de La Laguna, Santa Cruz de Tenerife, España
| | - O T Gómez López
- Gerencia de Atención Primaria de Tenerife, Servicio Canario de la Salud, Santa Cruz de Tenerife, España; Área de Medina Preventiva y Salud Pública, Universidad de La Laguna, Santa Cruz de Tenerife, España
| | - M Dorta Espiñeira
- Gerencia de Atención Primaria de Tenerife, Servicio Canario de la Salud, Santa Cruz de Tenerife, España; Área de Medina Preventiva y Salud Pública, Universidad de La Laguna, Santa Cruz de Tenerife, España
| | - S Farrais Villalba
- Gerencia de Atención Primaria de Tenerife, Servicio Canario de la Salud, Santa Cruz de Tenerife, España
| | - A Cabrera de León
- Área de Medina Preventiva y Salud Pública, Universidad de La Laguna, Santa Cruz de Tenerife, España; Unidad de Investigación de la Gerencia de Atención Primaria y del Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, España.
| | - Armando Aguirre-Jaime
- Servicio de Investigación en Cuidados del Colegio de Enfermer@s, Santa Cruz de Tenerife, España
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Mateo-Gallego R, Gracia-Rubio I, Garza MC, Cebollada A, Pérez-Calahorra S, Bayona-Sánchez A, Bujeda-Hernández C, Jarauta E, Sánchez-Calavera MA, Lamiquiz-Moneo I. The impact of the COVID-19 pandemic in diabetes and dyslipidemia management in a Spanish region: a retrospective study of the Aragon population. Front Med (Lausanne) 2023; 10:1191026. [PMID: 37484851 PMCID: PMC10359133 DOI: 10.3389/fmed.2023.1191026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 06/05/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction Previous research has indicated that the COVID-19 outbreak had a negative impact on the diagnosis and management of cardiometabolic diseases. Our aim was to analyze the impact of the COVID-19 pandemic on the management of dyslipidemia and type 2 diabetes (T2D) in the Aragon region of Spain. Methods We conducted an observational retrospective study, which included data from all patients diagnosed with active T2D or dyslipidemia in Aragon during 2019-2021. Data was collected from the BIGAN platform, a big database that includes all healthcare data from the Aragon population. Clinical, biochemical, and pharmacological prescription information was obtained for each patient and for each year. Results Out of the total population of 1,330,000 in the Aragon region, 90,000 subjects were diagnosed with T2D each year, resulting in a prevalence of approximately 7%. The COVID-19 pandemic resulted in a decrease in the prevalence of this disease and a lower incidence during the year 2020. In addition, patients with T2D experienced a deterioration of their glucose profile, which led to an increase in the number of patients requiring pharmacological therapy. The prevalence of dyslipidemia was approximately 23.5% in both 2019 and 2020 and increased to 24.5% in 2021. Despite the worsening of the anthropometric profile, the lipid profile improved significantly throughout 2020 and 2021 compared to 2019. Moreover, the number of active pharmacological prescriptions increased significantly in 2021. Discussion Our findings suggest that the overload of the health system caused by the COVID-19 pandemic has resulted in an underdiagnosis of T2D. Moreover, patients with T2D experienced a worsening of their glycemic profile, an increase in their pharmacological requirements, and lower performance of their analytical determinations. Dyslipidemic subjects improved their lipid profile although the value of lipid profile determination decreased between 2020 and 2021.
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Affiliation(s)
- Rocio Mateo-Gallego
- Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón (IIS Aragón), CIBERCV, Zaragoza, Spain
- Department of Physiatry and Nursing, Faculty of Health and Sports Sciences, University de Zaragoza, Huesca, Spain
| | - Irene Gracia-Rubio
- Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón (IIS Aragón), CIBERCV, Zaragoza, Spain
| | - María Carmen Garza
- Department of Human Anatomy and Histology, School Medicine, University of Zaragoza, Zaragoza, Spain
| | - Alberto Cebollada
- Computation Unit, Instituto Aragonés de Ciencias de la Salud (IACS Aragón), Zaragoza, Spain
| | - Sofía Pérez-Calahorra
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
| | - Ana Bayona-Sánchez
- Department of Human Anatomy and Histology, School Medicine, University of Zaragoza, Zaragoza, Spain
| | | | - Estibaliz Jarauta
- Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón (IIS Aragón), CIBERCV, Zaragoza, Spain
- Department of Medicine and Psychiatry, University of Zaragoza, Zaragoza, Spain
| | - Maria Antonia Sánchez-Calavera
- Department of Medicine and Psychiatry, University of Zaragoza, Zaragoza, Spain
- Health Research Institute of Aragon (IIS Aragón), Zaragoza, Spain
- Research Network on Preventive Activities and Health Promotion (Red de Investigación en Actividades Preventivas y Promoción de la Salud), Barcelona, Spain
- Aragones Health Service, Zaragoza, Spain
| | - Itziar Lamiquiz-Moneo
- Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón (IIS Aragón), CIBERCV, Zaragoza, Spain
- Department of Human Anatomy and Histology, School Medicine, University of Zaragoza, Zaragoza, Spain
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