The Impact of the COVID-19 Pandemic on Self-Reported Outcomes in Patients With Adrenal Insufficiency.
J Clin Endocrinol Metab
; 106(7): e2469-e2479, 2021 06 16.
Article
in English
| MEDLINE | ID: covidwho-1247625
ABSTRACT
CONTEXT The COVID-19 pandemic has impacted healthcare environment. OBJECTIVE:
To determine the impact of the pandemic on self-reported outcomes in patients with adrenal insufficiency (AI). DESIGN ANDSETTING:
Prospective longitudinal survey study at 2 tertiary centers.PARTICIPANTS:
Patients with AI. INTERVENTION Patient-centered questionnaire. MAIN OUTCOMEMEASURES:
Depression Anxiety Stress Scales-21, Short Form-36, and AI self-management.RESULTS:
Of 342 patients, 157 (46%) had primary AI, 109 (32%) had secondary AI, and 76 (22%) had glucocorticoid-induced AI. When compared to prepandemic, daily glucocorticoid dose and number of adrenal crises did not change. However, patients reported a higher financial impact from AI (34% vs 23%, Pâ =â 0.006) and difficulty accessing medical care (31% vs 7%, Pâ <â 0.0001) during the pandemic. A third of patients reported difficulty managing AI during the pandemic. After adjusting for duration and subtypes of AI, younger patients [odds ratio (OR) 2.3, CI 95% 1.3-4.1], women (OR 3.7, CI 95% 1.9-7.1), poor healthcare access(OR 4.2, CI 95% 2.3-7.7), lack of good insurance support (OR 2.8, CI 95% 1.3-5.9), and those with a higher financial impact (OR 2.3, CI 95% 1.3-4.3) reported greater difficulties managing AI. Patients were more likely to report a higher anxiety score (≥8) if they found managing AI challenging during the pandemic (OR 3.0, CI 95% 1.3-6.9), and had lower Physical Component Summary (OR 4.9, CI 95% 2.2-11.0) and Mental Component Summary (OR 4.1, CI 95% 1.8-9.5) scores prior to the pandemic.CONCLUSIONS:
A third of patients with AI reported difficulties with management of AI during the pandemic, particularly in younger patients, women, and those with poor healthcare access.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Anxiety
/
Adrenal Insufficiency
/
Patient Reported Outcome Measures
/
Self-Management
/
COVID-19
Type of study:
Cohort study
/
Diagnostic study
/
Experimental Studies
/
Observational study
/
Prognostic study
/
Qualitative research
Country/Region as subject:
North America
Language:
English
Journal:
J Clin Endocrinol Metab
Year:
2021
Document Type:
Article
Affiliation country:
Clinem
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