Impact of COVID-19 Pandemic on Adherence to Chronic Therapies: A Systematic Review.

The spread of the coronavirus disease 2019 (COVID-19) pandemic caused a sudden and significant disruption in healthcare services, especially for patients suffering from chronic diseases. We aimed at evaluating the impact of the pandemic on adherence to chronic therapies through a systematic review of available studies. PubMed, EMBASE, and Web of Science were searched since inception to June 2022. Inclusion criteria were: (1) observational studies or surveys; (2) studies on patients with chronic diseases; (3) reporting the effects of COVID-19 pandemic on adherence to chronic pharmacological treatment, as a comparison of adherence during the pandemic period vs. pre-pandemic period (primary outcome) or as rate of treatment discontinuation/delay specifically due to factors linked to COVID-19 (secondary outcome). Findings from 12 (primary outcome) and 24 (secondary outcome) studies showed that many chronic treatments were interrupted or affected by a reduced adherence in the pandemic period, and that fear of infection, difficulty in reaching physicians or healthcare facilities, and unavailability of medication were often reported as reasons for discontinuation or modification of chronic therapies. For other therapies where the patient was not required to attend the clinic, continuity of treatment was sometimes ensured through the use of telemedicine, and the adherence was guaranteed with drug stockpiling. While the effects of the possible worsening of chronic disease management need to be monitored over time, positive strategies should be acknowledged, such as the implementation of e-health tools and the expanded role of community pharmacists, and may play an important role in preserving continuity of care for people with chronic diseases.

The impact of COVID-19 on chronic therapies: the Pescara (ASL) local health authority experience in Italy.

INTRODUCTION: At this time in history fraught with restrictions and issues stemming from the COVID-19 pandemic, the care and management of chronic therapies is a major concern for society. The objective of the following study was to assess whether adherence and persistence in patients treated with hypoglycaemic drugs and statins during 2020 changed in comparison with pre-pandemic years. MATERIALS AND METHODS: A retrospective study was conducted, taking into account the drugs dispensed at pharmacies in the territory of the ASL (Local Health Authority) of Pescara from January 1, 2011 to December 2020 of all patients treated with ATC A10B (hypoglycaemic group) and ATC C10A (statin group). Adherence was calculated using the Proportion of days covered (PDC) method. Persistence to treatment was calculated as the difference in days between the start and end of therapy. RESULTS: A total of 12,030 patients treated with hypoglycaemic drugs and 19,699 with statins were analysed. Adherence data ranged from values of 0.79 and 0.75 in 2012 to 0.92 and 0.79 in 2020 for the hypoglycaemic group and statin group, respectively. Persistence curves stratified by year showed a statistically significant difference for both groups under analysis (p < .0001). CONCLUSIONS: The adherence figure did not change much, unlike the persistence figure. In fact, during 2020, the great impact that COVID-19 had on follow-up visits, on the availability of drugs, and on the difficulty of access to health facilities resulted in chronic patients abandoning therapy.