Diferencias en la atención a pacientes con diabetes mellitus tipo 2 y con hipertensión arterial durante una epidemia.Un estudio multicéntrico en Atención Primaria
- Francisco Javier Cuevas Fernández 1
- Olga Tatiana Gómez López 1
- Mercedes Dorta Espiñeira 1
- Anabela Enebral Quintana 2
- Antonio Cabrera de León 3
- Armando Aguirre-Jaime 4
- 1 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)
- 2 Servicio de Medicina Preventiva. Complejo Hospitalario Universitario Nuestra Señora de Candelaria. Santa Cruz de Tenerife (España)
- 3 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 Complejo Hospitalario Universitario Nuestra Señora de Candelaria. Santa Cruz de Tenerife (España)
- 4 Servicio de Apoyo a la Investigación en Cuidados. Colegio de Enfermeros de Santa Cruz de Tenerife (España)
ISSN: 2386-8201
Ano de publicación: 2024
Volume: 17
Número: 3
Páxinas: 162-170
Tipo: Artigo
Outras publicacións en: Revista Clínica de Medicina de Familia
Resumo
Objectives: to explore the relationship between the frequency of consultations of chronic patients and their monitoring during each year of the COVID-19 pandemic and over the total period 2019-2021. Methods: retrospective observational multicentre study in primary care in seven university primary care centres in Tenerife, Canary Islands. Subjects: 4314 patients with type 2 diabetes (DM2), arterial hypertension (HT) or both diseases took part. Measurements: sex, age, annual in person and telephone consultations with the family doctor, blood pressure tests, tests, and follow-up electrocardiogram and HbA1c and blood pressure as a control. Results: patients with a median age of 69 (48-87) years, of whom 2551 (59%) were aged older than 65 years, 2123 (49%) were women. A total of 709 suffered DM2 (16%), 770 HT (18%), and 2835 (66%) underwent both illnesses. Increasing the number of in person or telephone consultations was associated with better monitoring of these conditions, with odds ratios that increased between 1012 (1003-1024) and 1179 (1126-1234) for each additional consultation, calculated annually or over the period; age was a less important explanatory factor. Patients with HT revealed the worst results in the annual monitoring objective and over the period 2019-2021 (P<0.001). Conclusions: in Primary Care there is a direct relationship between frequency and monitoring of DM2, HT or their combination, mediated by the patient's age. Patients with HT suffer worse care and monitoring than those with DM2 or DM2 and HT. Phone consultations could be a useful tool for monitoring these patients.
Información de financiamento
Financiadores
Referencias bibliográficas
- Ali DH, Kiliç B, Hart HE, Bots ML, Biermans MCJ, Spiering W, et al. Therapeutic inertia in the management of hypertension in primary care. J Hypertens. 2021;39(6):1238-45. DOI: 10.1097/HJH.0000000000002783.
- Aubert CE, Henderson JB, Kerr EA, Holleman R, Klamerus ML, Hofer TP. Type 2 Diabetes Management, Control and Outcomes During the COVID-19 Pandemic in Older US Veterans: an Observational Study. J Gen Intern Med. 2022 Mar;37(4):870-7. doi:10.1007/s11606-021-07301-7. Epub 2022 Jan 6.
- Cheng AYY, Harris S, Krawchenko I, Tytus R, Hahn J, Liu A, et al. Impact of the COVD-19 Pandemic on Adults with Type 2 Diabetes Care and Clinical Parameters in a Primary Care Setting in Ontario, Canada: A Cross-sectional Study. Can J Diabetes. 2023;47:345-51. DOI: 10.1016/j.jcjd.2023.01.003.
- Collaboration NCDRF Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants. Lancet. 2021;398:957-80. DOI: 10.1016/S0140-6736(21)01330-1.
- Cucinotta D, Vanelli M. WHO declares COVID-19 a pandemic. Acta Biomed. 2020;91:157-60. doi: 10.23750/abm.v91i1.9397.
- Di Gangi S, Lüthi B, Díaz Hernández L, Zeller A, Zechmann S, Fischer R. Quality outcome of diabetes care during COVID-19 pandemic: a primary care cohort study. Acta Diabetol. 2022;59:1189-200. DOI: 10.1007/s00592-022-01920-0.
- Domínguez LW, Willis JS. COVID-19 and the Case for Medical Management and Primary Care. J Prim Care Community Health. 2020: 11:2150132720965080. DOI: 10.1177/2150132720965080.
- Fikree S, Hafid S, Lawson J, Agarwal J, Griffith LE, Jaakkimainen L, et al. The association between patients' frailty status, multimorbidity, and demographic characteristics and changes in primary care for chronic conditions during the COVID-19 pandemic: a pre-post study. Fam Pract. 2023;40(4):523-30. DOI: 10.1093/fampra/cmad089.
- Gomes-de-Almeida S, Marabujo T, Carmo-Gonçalves M. Grado de satisfacción de los pacientes de la Unidad de Salud Familiar Vitrius con la teleconsulta durante la pandemia del COVID-19. Semergen. 2021;47(4):248-55. DOI: 10.1016/j.semerg.2021.01.005. Epub 2021 Mar 11.
- Gonçalves RL, Pagano AS, Nogueira Reis ZS, Brackstone K, Pereira Lopes TC, Almeida Cordeiro S, et al. Usability of Telehealth Systems for Noncommunicable Diseases in Primary Care From the COVID-19 Pandemic Onward: Systematic Review. J Med Internet Res. 2023:25:e44209. DOI: 10.2196/44209.
- Gray C, Ambady L, Chao S, William Smith MPH, Yoon J. Virtual Management of Chronic Conditions During the COVID-19 pandemic: Insights from Primary Care Providers and Clinical Pharmacists. Mil Med. 2022:usac277. DOI: 10.1093/milmed/usac277. Online ahead of print. PMID: 36169929.
- Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708-20. DOI: 10.1056/NEJMoa2002032.
- Gupta SK, Lakshmi PVM, Kaur M, Rastogi A. Role of self−care in COVID−19 pandemic for people living with comorbidities of diabetes and hypertension. J Family Med Prim Care. 2020;9(11):5495-5501. DOI: 10.4103/jfmpc.jfmpc_1684_20. eCollection 2020 Nov.
- Hajat C, Stein E. The global burden of multiple chronic conditions: A narrative review. Prev Med Rep. 2018;12:284-93. DOI: 10.1016/j.pmedr.2018.10.008. eCollection 2018 Dec.
- Jackson SL, Block JP, Rolka DB, Pavkov ME, Chevinsky JR, Lekiachvili A, et al. COVID-19 Outcomes Stratified by Control Status of Hypertension and Diabetes: Preliminary Findings From PCORnet, U.S. AJPM Focus. 2022;1(1):100012. DOI: 10.1016/j.focus.2022.100012. Epub 2022 Jul 10.
- Jackson SL, Woodruff RC, Nagavedu K, Fearrington J, Rolka DB; Twentyman E, et al. Association Between Hypertension and Diabetes Control and COVID-19 Severity: National Patient-Centered Clinical Research Network, United States, March 2020 to February 2022. J Am Heart Assoc. 2023;12(21):e030240. DOI: 10.1161/JAHA.122.030240. Epub 2023 Oct 18.
- Kowall B, Kostev K, Landgraf R, Hauner H, Bierwirth R, Rathmann W. Effects of the COVID-19 pandemic on clinically diagnosed psychiatric disorders in persons with type 2 diabetes. Diabet Med. 2022;39:e14852. DOI: 10.1111/dme.14852.
- Marcelino-Rodríguez I, Elosua R, Pérez MC, Fernandez-Berges D, Guembe MJ, Vega Alonso T, et al. On the problem of type 2 diabetes-related mortality in the Canary Islands, Spain. The DARIOS Study. Diabetes Res Clin Pract. 2016;111:74-82. DOI: 10.1016/j.diabres.2015.10.024.
- Martín Enguix D, Sanchez Cambronero M, Aguirrre Rodriguez JC, Hidalgo Rodriguez A. Impact of COVID-19 on glycaemic control in a Spanish cohort of patients with type 2 diabetes. Practical Diabetes. 2022;39(1):7-11.
- Meador M, Coronado F, Roy D, Bay RC, Lewis JH, Chen J, et al. Impact of COVID-19-related care disruptions on blood pressure management and control in community health centers. BMC Public Health. 2022;22(1):2295. DOI: 10.1186/s12889-022-14763-9.
- Nozato Y, Yamamoto K, Rakugi H. Hypertension management before and under the COVID-19 pandemic: lessons and future directions. Hypertens Res. 2023;46(6):1471−7. DOI: 10.1038/s41440-023-01253-7. Epub 2023 Mar 30. PMID: 36997633.
- O'Shea PM, Griffin TP, Fitzgibbon M. Hypertension: The role of biochemistry in the diagnosis and management. Clin Chim Acta. 2017:465:131-43. DOI: 10.1016/j.cca.2016.12.014. Epub 2016 Dec 19.
- Parveen R, Sehar N, Bajpai R, Agarwal NB. Association of diabetes and hypertension with disease severity in covid-19 patients: A systematic literature review and exploratory meta-analysis, Diabetes Res Clin Pract. 2020:166:108295. DOI: 10.1016/j.diabres.2020.108295. Epub 2020 Jul 3.
- Red GDPS. Guía de diabetes tipo 2 para clínicos: recomendaciones red GDPS. 2018. [Consultado el 27 de julio de 2024]. Disponible en: https://www.redgdps.org/gestor/upload/colecciones /Guia%20DM2_web.pdf.
- Rodrigues Cimini CC, Maia JX, Carvalho Pires M, Bonisson Ribeiro L, Soares de Oliveira e Almeida Pinto V, Batchelor J, et al. Pandemic-Related Impairment in the Monitoring of Patients With Hypertension and Diabetes and the Development of a Digital Solution for the Community Health Worker: Quasiexperimental and Implementation Study. JMIR Med Inform. 2022 Mar 29;10(3):e35216. doi: 10.2196/35216.
- SEMERGEN. Análisis sobre la situación de los médicos de familia en España. [Consultado el 27 de julio de 2024]. Disponible en: https://semergen.es/files/docs/biblioteca/documentosInteres/dossier_prensa_analisis_situacion_semergen_map1%20(1).pdf
- Servicio Canario de la Salud. Programa EVA. [Consultado el 27 de julio de 2024]. Disponible en: https://www3.gobiernodecanarias.org/sanidad/scs/content/665e1471-d27e-11e2-8241-7543da9dbb8a/ProgramaEVAcompleto.pdf.
- Sisó-Almirall A, Kostov B, Sánchez E, Benavent-Areu J, Gonzalez de Paz L. Impact of the COVI-19 Pandemic on Primary Health Care Disease Incidences Rates: 2017 to 2020. Ann Fam Med. 2022;20(1):63-68. DOI: 10.1370/afm.2731. Epub 2021 Sep 24.
- Sociedad Española de Medicina Interna. La pandemia de COVID-19 se añadirá a la pandemia de pacientes crónicos que ya existía y supondrá una amenaza para el sistema sanitario. [Internet]. SEMI. [Consultado el 27 de julio de 2024]. Disponible en: https://www.fesemi.org/informacion/prensa/semi/la-pandemia-de-covid-19-se-anadira-la-pandemia-de-pacientes-cronicos-que-ya
- Steiner JF, J Powers JD, Malone A, Lyons J, Olson K, Paolino AR, et al. Hypertension care during the COVID-19 pandemic in an integrated health care system. J Clin Hypertens (Greenwich). 2023;25(4):315-25. DOI: 10.1111/jch.14641. Epub 2023 Mar 14.
- Stephenson E, Butt DA, Gronsbell J. Changes in the top 25 reasons for primary care visits during the COVID-19 pandemic in a high-COVID region of Canada PLoS One. 2021 Aug 12;16(8):e0255992. DOI: 10.1371/journal.pone.0255992. eCollection 2021.
- Tierney AA, Payán DD, Timothy T, Brown TT, Aguilera A, Shortell SM, Rodriguez HP. Telehealth Use, Care Continuity, and Quality: Diabetes and Hypertension Care in Community Health Centers Before and During the COVID-19 Pandemic. Med Care. 2023;61(1):S62-S69. DOI: 10.1097/MLR.0000000000001811. Epub 2023 Mar 9.
- Varandany S, Nagib ND. Evaluating the Impact of the COVID-19 Pandemic on Monthly Trends in Primary Care. Cureus. 2022 Aug 24;14(8):e28353. doi: 10.7759/cureus.28353. eCollection 2022 Aug.
- Williams B, Mancia G, Spiering W. 2018 Practice Guidelines for the management of arterial hypertension of the European Society of Hypertension and the European Society of Cardiology: ESH/ESC Task Force for the Management of Arterial Hypertension. J Hypertens. 2018;36(12):2284-309. DOI: 10.1097/HJH.0000000000001961.