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Sunkersing D, Ramasawmy M, Alwan NA, Clutterbuck D, Mu Y, Horstmanshof K, Banerjee A, Heightman M. What is current care for people with Long COVID in England? A qualitative interview study. BMJ Open 2024; 14:e080967. [PMID: 38760030 PMCID: PMC11107429 DOI: 10.1136/bmjopen-2023-080967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 05/01/2024] [Indexed: 05/19/2024] Open
Abstract
OBJECTIVE To investigate current care for people with Long COVID in England. DESIGN In-depth, semistructured interviews with people living with Long COVID and Long COVID healthcare professionals; data analysed using thematic analysis. SETTING National Health Service England post-COVID-19 services in six clinics from November 2022 to July 2023. PARTICIPANTS 15 healthcare professionals and 21 people living with Long COVID currently attending or discharged (18 female; 3 male). RESULTS Health professionals and people with lived experience highlighted the multifaceted nature of Long COVID, including its varied symptoms, its impact on people's lives and the complexity involved in managing this condition. These impacts encompass physical, social, mental and environmental dimensions. People with Long COVID reported barriers in accessing primary care, as well as negative general practitioner consultations where they felt unheard or invalidated, though some positive interactions were also noted. Peer support or support systems proved highly valuable and beneficial for individuals, aiding their recovery and well-being. Post-COVID-19 services were viewed as spaces where overlooked voices found validation, offering more than medical expertise. Despite initial challenges, healthcare providers' increasing expertise in diagnosing and treating Long COVID has helped refine care approaches for this condition. CONCLUSION Long COVID care in England is not uniform across all locations. Effective communication, specialised expertise and comprehensive support systems are crucial. A patient-centred approach considering the unique complexities of Long COVID, including physical, mental health, social and environmental aspects is needed. Sustained access to post-COVID-19 services is imperative, with success dependent on offering continuous rehabilitation beyond rapid recovery, acknowledging the condition's enduring impacts and complexities.
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Affiliation(s)
- David Sunkersing
- Institute of Health Informatics, University College London, London, UK
| | - Mel Ramasawmy
- Institute of Health Informatics, University College London, London, UK
| | - Nisreen A Alwan
- Academic Unit of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Donna Clutterbuck
- Academic Unit of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Yi Mu
- Institute of Health Informatics, University College London, London, UK
| | | | - Amitava Banerjee
- Institute of Health Informatics, University College London, London, UK
| | - Melissa Heightman
- University College London Hospitals NHS Foundation Trust, London, UK
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Tucknott S, McAteer H. Equity, expense, and expertise in biologic commissioning: adding the patient to the equation. Expert Opin Biol Ther 2024:1-9. [PMID: 38509688 DOI: 10.1080/14712598.2024.2326646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 02/29/2024] [Indexed: 03/22/2024]
Abstract
INTRODUCTION Immune-mediated inflammatory diseases (IMIDs) are increasingly managed effectively with biologic medicines. However, with relatively high unit costs, there remains a meaningful pressure to ensure streamlined, equitable, and inclusive prescription of biologics in the UK. Despite an increased awareness of the benefits of patient-centric shared decision making, patients remain on the periphery of biologic selection for the treatment of IMIDs. AREAS COVERED We provide a patient perspective on core issues in the commissioning, prescription, and decision making around biologics for IMIDs in the UK, focusing on England. In particular, the crucial aspect of determining 'value' for different stakeholders, who necessarily have different priorities, is considered. EXPERT OPINION There are disparities in commissioning, access to, and prescription of biologics for IMIDs in the UK. This creates an unequal treatment model and drives patient dissatisfaction with an 'experience lottery' for the management of disease. A more transparent approach to prescribing decisions, made in close consultation with patients, is essential for improving equity and experience with biologic treatment of IMIDs.
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Waheed U, Stedman M, Davies M, Solomon E, Taylor D, Heald A, Narayanan RP, Warner-Levy J. Changes in prescribing of psychotropic vs some physical health medication in primary care through the COVID-19 pandemic in England: a national-level survey. J Pharm Policy Pract 2023; 16:169. [PMID: 38124123 PMCID: PMC10734137 DOI: 10.1186/s40545-023-00655-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 11/07/2023] [Indexed: 12/23/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic globally impacted healthcare provision. Prescribing changes in common medications can be used as a marker for new diagnoses. We describe how the prescribing of specific psychotropics was impacted by the pandemic. METHODS Primary Care Prescribing data for different classes of drugs from March 2017 to February 2022 were considered. To capture the impact during periods of restricted access to health services for new diagnoses/existing conditions, repeat prescriptions/episodic prescribing were included with account taken of historical trends. The pre-pandemic prescriptions issued each month from March 2018 to February 2020 were linearly extrapolated forward to give an expected annual growth (EAG). The monthly average expected prescriptions for the pandemic period (March 2020-February 2022) were compared. RESULTS Physical health medications had lower monthly prescriptions during the pandemic, most markedly for antibiotics - 12.5% (EAG - 1.3%). Bronchodilator prescribing showed a marked increase in the early pandemic months from March 2020 of 5% (EAG 0.1%). Mental health medication prescribing increased above trend for hypnotics/anxiolytics by 0.2% (EAG - 2.3%), while antidepressants fell by - 0.2% (EAG 5.0%), with no net change for antipsychotics (EAG 2.8%), but a temporary increase in antipsychotic prescribing in the early pandemic period. For all the main antidepressants prescribed in England (Sertraline, Mirtazapine, Venlafaxine, Fluoxetine and Citalopram), prescribing actually decreased in the main pandemic period vs historical trend. CONCLUSIONS The increase in anxiolytic/hypnotic prescribing above trend links to pandemic effects on anxiety/worry. If anything, there was a slight fall in prescribing of the main antidepressants prescribed, which given prevailing circumstances at the time, suggests that access to services may have restricted access to timely assessment.
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Affiliation(s)
- Unaiza Waheed
- Department of Diabetes and Endocrinology, Salford Royal Hospital, Salford, M6 8HD, UK
| | - Mike Stedman
- The School of Medicine and Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | | | - Emma Solomon
- Department of Clinical Psychology, Salford Royal Hospital, Salford, UK
| | | | - Adrian Heald
- Department of Diabetes and Endocrinology, Salford Royal Hospital, Salford, M6 8HD, UK.
- The School of Medicine and Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK.
| | - Ram Prakash Narayanan
- St Helens and Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK
| | - John Warner-Levy
- The School of Medicine and Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
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Wieringa S, Neves AL, Rushforth A, Ladds E, Husain L, Finlay T, Pope C, Greenhalgh T. Safety implications of remote assessments for suspected COVID-19: qualitative study in UK primary care. BMJ Qual Saf 2023; 32:732-741. [PMID: 35260414 PMCID: PMC8927927 DOI: 10.1136/bmjqs-2021-013305] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 02/05/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND The introduction of remote triage and assessment early in the pandemic raised questions about patient safety. We sought to capture patients and clinicians' experiences of the management of suspected acute COVID-19 and generate wider lessons to inform safer care. SETTING AND SAMPLE UK primary healthcare. A subset of relevant data was drawn from five linked in-pandemic qualitative studies. The data set, on a total of 87 participants recruited via social media, patient groups and snowballing, comprised free text excerpts from narrative interviews (10 survivors of acute COVID-19), online focus groups (20 patients and 30 clinicians), contributions to a Delphi panel (12 clinicians) and fieldnotes from an online workshop (15 patients, clinicians and stakeholders). METHODS Data were uploaded onto NVivo. Coding was initially deductive and informed by WHO and Institute of Medicine frameworks of quality and safety. Further inductive analysis refined our theorisation using a wider range of theories-including those of risk, resilience, crisis management and social justice. RESULTS In the early weeks of the pandemic, patient safety was compromised by the driving logic of 'stay home' and 'protect the NHS', in which both patients and clinicians were encouraged to act in a way that helped reduce pressure on an overloaded system facing a novel pathogen with insufficient staff, tools, processes and systems. Furthermore, patients and clinicians observed a shift to a more transactional approach characterised by overuse of algorithms and decision support tools, limited empathy and lack of holistic assessment. CONCLUSION Lessons from the pandemic suggest three key strategies are needed to prevent avoidable deaths and inequalities in the next crisis: (1) strengthen system resilience (including improved resourcing and staffing; support of new tools and processes; and recognising primary care's role as the 'risk sink' of the healthcare system); (2) develop evidence-based triage and scoring systems; and (3) address social vulnerability.
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Affiliation(s)
- Sietse Wieringa
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Ana Luisa Neves
- Centre for Health Policy, Institute of Global Health Innovation, Imperial College London, London, UK
| | - Alexander Rushforth
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
- CWTS, University of Leiden, Leiden, The Netherlands
| | - Emma Ladds
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Laiba Husain
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Teresa Finlay
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Catherine Pope
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
- NIHR CLAHRC Wessex, University of Southampton, Southampton, UK
| | - Trisha Greenhalgh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Villalobos-Quesada M, Ho K, Chavannes NH, Talboom-Kamp EPWA. Direct-to-patient digital diagnostics in primary care: Opportunities, challenges, and conditions necessary for responsible digital diagnostics. Eur J Gen Pract 2023; 29:2273615. [PMID: 37947197 PMCID: PMC10653613 DOI: 10.1080/13814788.2023.2273615] [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: 04/04/2023] [Accepted: 10/09/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Diagnostics are increasingly shifting to patients' home environment, facilitated by new digital technologies. Digital diagnostics (diagnostic services enabled by digital technologies) can be a tool to better respond to the challenges faced by primary care systems while aligning with patients' and healthcare professionals' needs. However, it needs to be clarified how to determine the success of these interventions. OBJECTIVES We aim to provide practical guidance to facilitate the adequate development and implementation of digital diagnostics. STRATEGY Here, we propose the quadruple aim (better patient experiences, health outcomes and professional satisfaction at lower costs) as a framework to determine the contribution of digital diagnostics in primary care. Using this framework, we critically analyse the advantages and challenges of digital diagnostics in primary care using scientific literature and relevant casuistry. RESULTS Two use cases address the development process and implementation in the Netherlands: a patient portal for reporting laboratory results and digital diagnostics as part of hybrid care, respectively. The third use case addresses digital diagnostics for sexually transmitted diseases from an international perspective. CONCLUSIONS We conclude that although evidence is gathering, the often-expected value of digital diagnostics needs adequate scientific evidence. We propose striving for evidence-based 'responsible digital diagnostics' (sustainable, ethically acceptable, and socially desirable digital diagnostics). Finally, we provide a set of conditions necessary to achieve it. The analysis and actionable guidance provided can improve the chance of success of digital diagnostics interventions and overall, the positive impact of this rapidly developing field.
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Affiliation(s)
- María Villalobos-Quesada
- Department of Public Health and Primary Care, National eHealth Living Lab, Leiden University Medical Centre, Leiden, The Netherlands
| | - Kendall Ho
- Department of Emergency Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Cloud Innovation Centre for Community Health and Wellbeing, University of British Columbia, Vancouver, Canada
| | - Niels H. Chavannes
- Department of Public Health and Primary Care, National eHealth Living Lab, Leiden University Medical Centre, Leiden, The Netherlands
| | - Esther PWA Talboom-Kamp
- Department of Public Health and Primary Care, National eHealth Living Lab, Leiden University Medical Centre, Leiden, The Netherlands
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Owen R, Ashton RE, Ferraro FV, Phillips BE, Skipper L, Faghy MA. Acute COVID-19, the Lived Experience, and Lessons to Learn for Future Pandemics. Disaster Med Public Health Prep 2023; 17:e534. [PMID: 37990549 DOI: 10.1017/dmp.2023.197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2023]
Abstract
OBJECTIVES The study aimed to increase the understanding of the lived experience of patients during the acute phase of a coronavirus disease 2019 (COVID-19) infection. METHOD A Web-based survey was distributed through established patient and public engagement and involvement groups and networks, social media, and by means of word of mouth. The survey covered questions relating to patient demographics, COVID-19 diagnosis, symptom profile, and patient experience during acute COVID-19. RESULTS The findings demonstrate the varying symptom profiles experienced by people in the acute stage of COVID-19 infection, with participants sharing how they managed care at home, and/or accessed medical advice. Findings also highlight themes that people were concerned with being unable to receive care and believed they needed to rely heavily on family, with extreme thoughts of death. CONCLUSIONS Although the urgent threat to public health has been negated by efficacious vaccines and enhanced treatment strategies, there are key lessons from the lived experience of COVID-19 that should be used to prepare for future pandemics and public health emergencies.
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Affiliation(s)
- Rebecca Owen
- Biomedical Research Theme, School of Human Sciences, University of Derby, Derby, UK
| | - Ruth Em Ashton
- Biomedical Research Theme, School of Human Sciences, University of Derby, Derby, UK
- Healthy Living for Pandemic Event Protection Network (HL-Pivot), Chicago, USA
| | - Francesco V Ferraro
- Biomedical Research Theme, School of Human Sciences, University of Derby, Derby, UK
| | - Bethan E Phillips
- School of Medicine, MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and National Institute for Health Research Nottingham Biomedical Research Centre, University of Nottingham, Derby, UK
| | - Lindsay Skipper
- Patient and Public Involvement and Engagement Representative, UK
| | - Mark A Faghy
- Biomedical Research Theme, School of Human Sciences, University of Derby, Derby, UK
- Healthy Living for Pandemic Event Protection Network (HL-Pivot), Chicago, USA
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Park YT, Lane C, Lee HJ, Lee J. Was size of healthcare institution a factor affecting changes in healthcare utilisation during the COVID-19 pandemic in Korea? A retrospective study design analysing national healthcare big data. BMJ Open 2022; 12:e064537. [PMID: 36600350 PMCID: PMC9729846 DOI: 10.1136/bmjopen-2022-064537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES Many small-sized healthcare institutions play a critical role in communities by preventing infectious diseases. This study examines how they have been impacted by the global COVID-19 pandemic compared with large hospitals. DESIGN This study adopted a retrospective study design looking back at the healthcare utilisation of medical facilities according to size after the COVID-19 pandemic. The dependent variable was change in the number of outpatient health insurance claims before and after onset of the COVID-19 pandemic. The independent variable was an observation time point of the year 2020 compared with 2019. SETTING AND PARTICIPANTS The study was conducted in Korea having a competitive medical provision environment under the national health insurance system. The units of analysis are hospitals and clinics: tertiary hospitals (42), general hospitals (293), small hospitals (1272) and medical clinics (27 049). This study analysed all the health insurance claim data from 1 January 2019 to 31 December 2020. RESULTS Compared with 2019, in 2020, there were significant decreases in the number of claims (-14.9%), particularly in small hospitals (-16.8%) and clinics (-16.3%), with smaller decreases in general hospitals (-8.9%) and tertiary hospitals (-5.3%). The reduction in healthcare utilisation increased as the size of institutions decreased. The magnitude of decrease was significantly greatest in small hospitals (absolute risk (AR): 0.8317, 0.7758 to 0.8915, p<0.0001; relative risk (RR): 0.8299, 0.7750 to 0.888, p<0.0001) followed by clinics (AR: 0.8369, 0.8262 to 0.8478, p<0.0001; RR: 0.8362, 0.8255 to 0.8470, p<0.0001) even after controlling institutional covariates. CONCLUSION The external impact of the pandemic increased incrementally as the size of healthcare institutions decreased. Healthcare policy-makers need to keep in mind the possibility that small hospitals and clinics may experience reduced healthcare utilisation in the infectious disease pandemic. This fact has political implications for how healthcare policy-makers should prepare for the next infectious disease pandemic.
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Affiliation(s)
- Young-Taek Park
- HIRA Research Institute, Health Insurance Review & Assessment Service, Wonju-si, Korea (the Republic of)
| | - Chris Lane
- Health Workforce, Health New Zealand, Wellington, New Zealand
| | - Hyun-Ji Lee
- Department of Health Administration, Yonsei University Graduate School, Wonju-si, Korea (the Republic of)
| | - Jinhyung Lee
- Department of Economics, Sungkyunkwan University, Jongno-gu, Korea (the Republic of)
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8
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Ekezie W, Maxwell A, Byron M, Czyznikowska B, Osman I, Moylan K, Gong S, Pareek M. Health Communication and Inequalities in Primary Care Access during the COVID-19 Pandemic among Ethnic Minorities in the United Kingdom: Lived Experiences and Recommendations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192215166. [PMID: 36429886 PMCID: PMC9690007 DOI: 10.3390/ijerph192215166] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/05/2022] [Accepted: 11/11/2022] [Indexed: 05/20/2023]
Abstract
Health Communication is critical in the context of public health and this was highlighted during the COVID-19 pandemic. Ethnic minority groups were significantly impacted during the pandemic; however, communication and information available to them were reported to be insufficient. This study explored the health information communication amongst ethnic communities in relation to their experiences with primary health care services during the COVID-19 pandemic. The research used qualitative methodology using focus groups and semi-structured interviews with community members and leaders from three ethnic minority communities (African-Caribbean, Somali and South Asian) in Leicester, United Kingdom. The interviews were audio recorded, transcribed, and open-coded. Rigour was determined through methodological coherence, appropriate and sufficient sampling, and iterative data collection and analysis. Six focus groups and interviews were conducted with 42 participants. Four overarching themes were identified related to health communication, experiences, services and community recommendations to improve primary care communication. To address primary care inequalities effectively and improve future health communication strategies, experiences from the pandemic should be reflected upon, and positive initiatives infused into the healthcare strategies, especially for ethnic minority communities.
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Affiliation(s)
- Winifred Ekezie
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester LE5 4PW, UK
- Centre for Ethnic Health Research, University of Leicester, Leicester LE5 4PW, UK
- Correspondence:
| | - Akilah Maxwell
- School of Media, Communication and Sociology, University of Leicester, Leicester LE1 7RH, UK
| | - Margaret Byron
- School of Geography, Geology and the Environment, University of Leicester, Leicester LE1 7RH, UK
| | - Barbara Czyznikowska
- Centre for Ethnic Health Research, University of Leicester, Leicester LE5 4PW, UK
| | - Idil Osman
- School of Media, Communication and Sociology, University of Leicester, Leicester LE1 7RH, UK
| | - Katie Moylan
- School of Media, Communication and Sociology, University of Leicester, Leicester LE1 7RH, UK
| | - Sarah Gong
- School of Media, Communication and Sociology, University of Leicester, Leicester LE1 7RH, UK
| | - Manish Pareek
- Department of Respiratory Sciences, University of Leicester, Leicester LE1 9HN, UK
- National Institute for Health Research, Leicester Biomedical Research Centre, Leicester LE3 9QP, UK
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Goyal D. An untrustworthy government during a pandemic-a lethal combination. BMJ 2022; 377:o1011. [PMID: 35443986 DOI: 10.1136/bmj.o1011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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10
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Debski M, Tsampasian V, Haney S, Blakely K, Weston S, Ntatsaki E, Lim M, Madden S, Perperoglou A, Vassiliou VS. Post-COVID-19 syndrome risk factors and further use of health services in East England. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0001188. [PMID: 36962824 PMCID: PMC10022108 DOI: 10.1371/journal.pgph.0001188] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 10/24/2022] [Indexed: 12/05/2022]
Abstract
Post-COVID syndrome, defined as symptoms persisting for more than twelve weeks after the diagnosis of COVID-19, has been recognised as a new clinical entity in the context of SARS-CoV-2 infection. This study was conducted to characterise the burden and predictors for post-COVID-19 syndrome in the local population. It was a community-based web-survey study conducted in Norfolk, East England, UK. We sent the survey to patients with confirmed COVID-19 infection by real-time polymerase chain reaction by December 6th, 2020. Questions related to the pre-COVID and post-COVID level of symptoms and further healthcare use. Baseline characteristics were collected from the primary care records. Logistic regression analysis was conducted to establish predictors for post-COVID-19 syndrome and further healthcare utilisation. Of 6,318 patients, survey responses were obtained from 1,487 participants (23.5%). Post-COVID-19 syndrome symptoms were experienced by 774 (52.1%) respondents. Male sex compared to female sex was a factor protective of post-COVID symptoms; relative risk (RR) 0.748, 95% confidence interval (CI), 0.605-0.924. Body mass index was associated with a greater risk of developing post-COVID-19 symptoms (RR 1.031, 95% CI, 1.016-1.047, for 1 kg/m2). A total of 378 (25.4%) people used further health services after their index COVID-19 infection, of whom 277 (73.2%) had post-COVID symptoms. Male sex was negatively associated with the use of further health services (RR 0.618, 95% CI, 0.464-0.818) whereas BMI was positively associated (RR 1.027, 95% CI, 1.009-1.046). Overall, post-COVID-19 symptoms increased the probability of using health services with RR 3.280, 95% CI, 2.540-4.262. This survey of a large number of people previously diagnosed with COVID-19 across East England shows a high prevalence of self-reported post-COVID-19 syndrome. Female sex and BMI were associated with an increased risk of post-COVID-19 syndrome and further utilisation of healthcare.
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Affiliation(s)
- Maciej Debski
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
- Cardiology Department, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, United Kingdom
| | - Vasiliki Tsampasian
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
- Cardiology Department, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, United Kingdom
| | - Shawn Haney
- Norfolk and Waveney Integrated Care Board, Norwich, United Kingdom
| | - Katy Blakely
- Cardiology Department, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, United Kingdom
- Norfolk and Waveney Integrated Care Board, Norwich, United Kingdom
| | - Samantha Weston
- Norfolk and Waveney Integrated Care Board, Norwich, United Kingdom
| | - Eleana Ntatsaki
- Rheumatology Department, East Suffolk and North Essex Foundation NHS Trust, Ipswich Hospital, Ipswich, United Kingdom
- Centre for Rheumatology, University College London, London, United Kingdom
| | - Mark Lim
- Norfolk and Waveney Integrated Care Board, Norwich, United Kingdom
| | - Susan Madden
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Aris Perperoglou
- School of Mathematics, Statistics and Physics, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Vassilios S Vassiliou
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
- Cardiology Department, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, United Kingdom
- Institute of Continuing Education, University of Cambridge, Cambridge, United Kingdom
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