Patient Preference and Adherence (Aug 2023)
Impact of COVID-19 Lockdown on Glycemic, Weight, Blood Pressure Control and Medication Adherence in Patients with Type 2 Diabetes
Abstract
Ruth Sim,1 Chun Wie Chong,1 Navin Kumar Loganadan,2 Zanariah Hussein,3 Noor Lita Adam,4 Shaun Wen Huey Lee1,5– 7 1School of Pharmacy, Monash University Malaysia, Subang Jaya, Selangor, Malaysia; 2Department of Pharmacy, Putrajaya Hospital, Ministry of Health Malaysia, Putrajaya, Malaysia; 3Department of Medicine, Putrajaya Hospital, Ministry of Health Malaysia, Putrajaya, Malaysia; 4Department of Medicine, Hospital Tuanku Jaafar, Ministry of Health Malaysia, Seremban, Negeri Sembilan, Malaysia; 5School of Pharmacy, Faculty of Health and Medical Sciences, Taylor’s University, Subang Jaya, Selangor, Malaysia; 6Asian Centre for Evidence Synthesis in Population, Implementation and Clinical Outcomes (PICO), Monash University Malaysia, Bandar Sunway, Selangor, Malaysia; 7Center for Global Health, University of Pennsylvania, Philadelphia, PA, USACorrespondence: Shaun Wen Huey Lee, School of Pharmacy, Monash University Malaysia, Subang Jaya, Selangor, Malaysia, Tel +60 3 5514 5890, Email [email protected]: Medication adherence profoundly affects blood glucose management in patients with type 2 diabetes. Measures to contain the COVID-19 pandemic have affected disease management and medication adherence, owing to limited access to healthcare facilities. This study aimed to examine the impact of the COVID-19 lockdown on adherence to glucose-lowering and lipid-lowering therapies (statins), and glycemic, weight, and systolic blood pressure control measures. A retrospective chart review was conducted one year pre- and post- March 18, 2020, for patients receiving glucose-lowering medications and lipid-lowering therapies (statins) in two major public hospitals in Malaysia. We compared the proportion of days covered by medication, HbA1c level, weight, and systolic blood pressure (SBP) values pre- and after the index date. A total of 1985 patients were included in this study. The adherence rate significantly increased for metformin, sulfonylureas dipeptidyl peptidase 4 inhibitors (DPP4i) and statin after the index date (metformin (PDC: 0.985 vs 0.978, p < 0.001), sulfonylureas (PDC: 0.988 vs 0.979, p < 0.01), DPP4i (PDC: 0.987 vs 0.98, p < 0.001), and statins (PDC: 0.983 vs 0.978, p < 0.05)). HbA1c levels were significantly reduced after the index follow-up (Mean difference: − 0.43%, p < 0.001), while there was a 2.5 mmHg (p = 0.03) significant increase in SBP post-index follow-up. No significant changes in weight were observed during the post-index follow-up period. In this study, we observed better medication adherence and glycemic control among patients during the lockdown, but not for weight and systolic blood pressure control.Graphical Abstract: Keywords: diabetes, covid-19, SARS-CoV 2, adherence, weight, glycemic
