COVID-19: GP contacts drop most for diabetic emergencies

  • Mansfield KE & al.
  • Lancet Digit Health
  • 18 Feb 2021

  • curated by Dawn O'Shea
  • UK Medical News
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After the introduction of COVID-19 restrictions, the drop-offs in GP contacts were largest for diabetic emergencies, depression and self-harm, reports new research published in the Lancet Digital Health.

Using de-identified electronic health records from the Clinical Research Practice Datalink Aurum (covering 13% of the UK population), between 2017 and 2020, researchers from the London School of Hygiene & Tropical Medicine calculated weekly primary care contacts for selected acute physical and mental health conditions including:

  • anxiety;
  • depression;
  • self-harm (fatal and non-fatal);
  • severe mental illness;
  • eating disorder;
  • obsessive-compulsive disorder (OCD);
  • acute alcohol-related events;
  • asthma exacerbation;
  • chronic obstructive pulmonary disease exacerbation;
  • acute cardiovascular events (cerebrovascular accident, heart failure, myocardial infarction, transient ischaemic attacks, unstable angina and venous thromboembolism); and
  • diabetic emergency.

An interrupted time-series analysis was conducted to formally quantify changes in conditions after the introduction of population-wide restrictions (29 March 2020) compared with the period before their introduction (defined as from 1 January 2017 to 7 March 2020), with data excluded for an adjustment-to-restrictions period (8-28 March).

The overall population included 9,863,903 individuals on 1 January 2017 and increased to 10,226,939 by 1 January 2020.

Primary care contacts for almost all conditions dropped considerably after the introduction of population-wide restrictions.

The largest reductions were observed for:

  • Diabetic emergencies (OR, 0.35; 95% CI, 0.5-0.50).
  • Depression (OR, 0.53; 95% CI, 0.52-0.53).
  • Self-harm (OR, 0.56; 95% CI, 0.54-0.58).

Except for acute alcohol-related events (OR, 0.98; 95% CI, 0.89-1.10), there was a reduction in contacts for all conditions:

  • Anxiety (OR, 0.67; 95% CI, 0.66-0.67).
  • Eating disorders (OR, 0.62; 95% CI, 0.59-0.66).
  • OCD (OR, 0.69; 95% CI, 0.64-0.74).
  • Self-harm (OR, 0.56; 95% CI, 0.54-0.58).
  • Severe mental illness (OR, 0.80; 95% CI, 0.78-0.83).
  • Stroke (OR, 0.59; 95% CI, 0.56-0.62).
  • Transient ischaemic attack (OR, 0.63; 95% CI, 0.58-0.67).
  • Heart failure (OR, 0.62; 95% CI, 0.60-0.64).
  • Myocardial infarction (OR, 0.72; 95% CI, 0.68-0.77).
  • Unstable angina (OR, 0.72; 95% CI, 0.60-0.87).
  • Venous thromboembolism (OR, 0.94; 95% CI, 0.90-0.99).
  • Asthma exacerbation (OR, 0.88; 95% CI, 0.86-0.90).

By July 2020, except for unstable angina and acute alcohol-related events, contacts for all conditions had not recovered to pre-lockdown levels.

"The conditions we studied are sufficiently severe that any unmet need will have substantial ramifications for the people with the conditions as well as health-care provision," the authors caution.