Clinical Epidemiology (Nov 2022)

Effects of COVID-19 Pandemic and Lockdown on Monitoring and Treatment Balance of Finnish Coronary Heart Disease and Type 2 Diabetes Patients

  • Lavikainen P,
  • Lamidi ML,
  • Repo T,
  • Inglin L,
  • Martikainen J,
  • Laatikainen T

Journal volume & issue
Vol. Volume 14
pp. 1363 – 1373

Abstract

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Piia Lavikainen,1 Marja-Leena Lamidi,2 Teppo Repo,3 Laura Inglin,2 Janne Martikainen,1 Tiina Laatikainen2,4 1School of Pharmacy, University of Eastern Finland, Kuopio, Finland; 2Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; 3Department of Geographical and Historical Studies, University of Eastern Finland, Joensuu, Finland; 4Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, FinlandCorrespondence: Piia Lavikainen, Tel +358 40 7024682, Email [email protected]: We aimed to examine the effect of the COVID-19 pandemic and lockdown on monitoring and treatment balance of Finnish coronary heart disease (CHD) and type 2 diabetes (T2D) patients.Patients and Methods: We used data from the electronic health records on 1604 CHD and 10,136 T2D patients aged 18‒85 years in Eastern Finland. Measurement and levels of low-density lipoprotein cholesterol (LDL) of CHD patients and glycated haemoglobin (HbA1c) of T2D patients were assessed monthly during January 2019–June 2021. Interrupted time-series analysis design was utilized to examine the effect of the lockdown on proportion of patients monitored and treatment balance.Results: Reductions in frequencies of LDL testing of CHD and HbA1c testing of T2D patients were observed during the national lockdown. Downward trend in average LDL was observed from January 2019 until June 2021. Average HbA1c values increased from January 2019 to March 2020 with an additional increase by 2.04 mmol/mol (0.80 to 3.29) in April 2020. However, there was a downward trend in monthly average HbA1c during the lockdown until June 2021 with an additional change in level by 0.61 mmol/mol (95% CI 0.06 to 1.16) in July 2020.Conclusion: The lockdown decreased the frequency of monitoring among both CHD and T2D patients. Meanwhile, monthly average LDL had a steadily improving pattern in CHD patients during the follow-up while temporary worsening in HbA1c in patients with T2D was observed at the time of the lockdown. The lockdown may have introduced selection in patients who had their treatment outcomes monitored. Better self-management of risk factors among patients is also possible.Keywords: HbA1c, LDL, interrupted time-series, electronic health records

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