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.
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).
- 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.