The Impact of the COVID-19 Pandemic on Medical Conditions and Medication Adherence in People with Chronic Diseases

Abstract: Background The coronavirus disease 2019 (COVID-19) pandemic has drastically disrupted primary healthcare and pharmacy services, posing a challenge in people with chronic diseases who receive routine care. Currently, there exists limited literature on the indirect impact of the pandemic on chronic disease management, particularly related to accessibility to medications and healthcare resources. Objectives To determine the prevalence of medical and medication-related problems reported by people with chronic diseases during the pandemic. Secondary objective was to identify the barriers and contributing factors related to these medical and medication-related problems. Methods The anonymous and voluntary, web-based survey was filled out by interested adult respondents with chronic disease(s) across Michigan between 9/1/2020 and 1/1/2021. Primary outcome included self-reported medical- and medication-related problems during the pandemic. Secondary outcomes included potential risk factors for medical- and medication-related problems. Descriptive statistics was used to describe respondents’ demographics, chronic disease(s) characteristics, medication adherence, medical- and medication-related problems, and COVID-19–related factors. The multivariable Firth logistic regression was used to analyze correlations between potential risk factors associated with medical- and medication-related problems. Results 1,103 respondents completed the survey and were included in the analysis. Approximately, 51% of respondents reported an medication-related problem with 19.6% reported problems obtaining medication(s) and 31.7% reported forgetting/not taking their medication(s). The top reason for problems obtaining medication(s) was doctor’s office being closed for in-person visit(s). Additionally, of all responses, more than half reported worsening symptoms of their chronic disease(s) during the pandemic especially with psychiatric disorders (79.5%) and inflammatory bowel disease (60%). Respondents with significantly higher risk of medication-related problems included being younger, being female, and having psychiatric disorder(s), diabetes or arthritis/lupus and of medical-related problems included having multiple chronic diseases, psychiatric disorder(s) and heart failure. Conclusion Understanding the consequences of the pandemic, such as medical- and medication-related problems, in this population is critical to improving healthcare accessibility and resources through potential outpatient pharmacy services during this and future pandemics.