Impacts of the COVID‑19 pandemic on the primary care of chronic conditions

Howard, Michelle I | $284,570

Ontario McMaster University 2022 CIHR Operating Grant

Family doctors and teams in primary care provide the majority of care for chronic diseases. The COVID‑19 pandemic has interrupted routine primary care. It is important that people with one or more chronic diseases can access their family doctor for routine check-ups, adjustments to medications and taking blood pressure, etc. This ongoing monitoring helps manage their condition and avoid a flare-up that could lead to hospitalization. Since the pandemic, most primary care shifted to virtual care, where a doctor talks to a patient by telephone or video. In-person visits have been reduced. Many patients have been afraid to visit a doctor’s office due to potential for infection, or they think their doctor cannot see them in person. This trend might have a negative impact on the management of chronic conditions. In this research, we will evaluate the impacts of COVID‑19 on chronic disease care, using a large database that anonymously compiles the electronic medical record data from over 1500 family doctors’ practices across Canada. We will look at conditions such as hypertension, diabetes, heart failure, and kidney disease, to evaluate changes in the detection and management of these conditions after pandemic restrictions began. We will examine whether changes disproportionately impact patients who are age 80 and older, with frailty, and if there are gender differences. To understand the reasons for gaps in care and possible solutions, we will interview patients with these conditions, and primary care physicians and nurses. We will ask about their experiences and what is most important to them for addressing chronic conditions, given that there may be a prolonged period of uncertainty in health care before things return to normal. This study will provide evidence on which specific aspects of primary care have been most impacted in the pandemic, and it will identify possible solutions to be recommended for recovering from the pandemic.

With funding from the Government of Canada

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