Health, psychosocial, and economic impacts of the COVID-19 pandemic on people with chronic conditions in India: a mixed methods study.

Autor: Singh K; Public Health Foundation of India, Plot number 47, Sector 44, Gurugram, New Delhi, Haryana, 122002, India. kavita.singh@phfi.org.; Centre for Chronic Disease Control, New Delhi, India. kavita.singh@phfi.org., Kondal D; Public Health Foundation of India, Plot number 47, Sector 44, Gurugram, New Delhi, Haryana, 122002, India., Mohan S; Public Health Foundation of India, Plot number 47, Sector 44, Gurugram, New Delhi, Haryana, 122002, India.; Centre for Chronic Disease Control, New Delhi, India.; Deakin University, Melbourne, Australia., Jaganathan S; Centre for Chronic Disease Control, New Delhi, India., Deepa M; Madras Diabetes Research Foundation, Chennai, India., Venkateshmurthy NS; Public Health Foundation of India, Plot number 47, Sector 44, Gurugram, New Delhi, Haryana, 122002, India.; Centre for Chronic Disease Control, New Delhi, India., Jarhyan P; Public Health Foundation of India, Plot number 47, Sector 44, Gurugram, New Delhi, Haryana, 122002, India., Anjana RM; Madras Diabetes Research Foundation, Chennai, India., Narayan KMV; Emory University, Atlanta, GA, USA., Mohan V; Madras Diabetes Research Foundation, Chennai, India., Tandon N; All India Institute of Medical Sciences, New Delhi, India., Ali MK; Emory University, Atlanta, GA, USA., Prabhakaran D; Public Health Foundation of India, Plot number 47, Sector 44, Gurugram, New Delhi, Haryana, 122002, India.; Centre for Chronic Disease Control, New Delhi, India.; London School of Hygiene and Tropical Medicine, London, UK., Eggleston K; Stanford University, Stanford, California, USA.
Jazyk: angličtina
Zdroj: BMC public health [BMC Public Health] 2021 Apr 08; Vol. 21 (1), pp. 685. Date of Electronic Publication: 2021 Apr 08.
DOI: 10.1186/s12889-021-10708-w
Abstrakt: Background: People with chronic conditions are disproportionately prone to be affected by the COVID-19 pandemic but there are limited data documenting this. We aimed to assess the health, psychosocial and economic impacts of the COVID-19 pandemic on people with chronic conditions in India.
Methods: Between July 29, to September 12, 2020, we telephonically surveyed adults (n = 2335) with chronic conditions across four sites in India. Data on participants' demographic, socio-economic status, comorbidities, access to health care, treatment satisfaction, self-care behaviors, employment, and income were collected using pre-tested questionnaires. We performed multivariable logistic regression analysis to examine the factors associated with difficulty in accessing medicines and worsening of diabetes or hypertension symptoms. Further, a diverse sample of 40 participants completed qualitative interviews that focused on eliciting patient's experiences during the COVID-19 lockdowns and data analyzed using thematic analysis.
Results: One thousand seven hundred thirty-four individuals completed the survey (response rate = 74%). The mean (SD) age of respondents was 57.8 years (11.3) and 50% were men. During the COVID-19 lockdowns in India, 83% of participants reported difficulty in accessing healthcare, 17% faced difficulties in accessing medicines, 59% reported loss of income, 38% lost jobs, and 28% reduced fruit and vegetable consumption. In the final-adjusted regression model, rural residence (OR, 95%CI: 4.01,2.90-5.53), having diabetes (2.42, 1.81-3.25) and hypertension (1.70,1.27-2.27), and loss of income (2.30,1.62-3.26) were significantly associated with difficulty in accessing medicines. Further, difficulties in accessing medicines (3.67,2.52-5.35), and job loss (1.90,1.25-2.89) were associated with worsening of diabetes or hypertension symptoms. Qualitative data suggest most participants experienced psychosocial distress due to loss of job or income and had difficulties in accessing in-patient services.
Conclusion: People with chronic conditions, particularly among poor, rural, and marginalized populations, have experienced difficulties in accessing healthcare and been severely affected both socially and financially by the COVID-19 pandemic.
Databáze: MEDLINE
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