Your browser doesn't support javascript.
Diagnosis of physical and mental health conditions in primary care during the COVID-19 pandemic: a retrospective cohort study.
Williams, Richard; Jenkins, David A; Ashcroft, Darren M; Brown, Ben; Campbell, Stephen; Carr, Matthew J; Cheraghi-Sohi, Sudeh; Kapur, Navneet; Thomas, Owain; Webb, Roger T; Peek, Niels.
  • Williams R; The National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK; Division of Informatics, Imaging and Data Science, University of Manchester, Manchester, UK. Electronic address: richard.williams@manchester.ac.uk.
  • Jenkins DA; The National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK; Division of Informatics, Imaging and Data Science, University of Manchester, Manchester, UK.
  • Ashcroft DM; The National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK; Division of Pharmacy and Optometry, University of Manchester, Manchester, UK.
  • Brown B; The National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK; Division of Informatics, Imaging and Data Science, University of Manchester, Manchester, UK; Division of Population Health, Health Services Research a
  • Campbell S; The National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK; Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK.
  • Carr MJ; The National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK.
  • Cheraghi-Sohi S; The National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK.
  • Kapur N; The National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK; Division of Psychology and Mental Health, University of Manchester, Manchester, UK; Greater Manchester Mental Health NHS Foundation Trust, Manchester,
  • Thomas O; Langworthy Medical Practice, Salford, UK.
  • Webb RT; The National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK; Division of Psychology and Mental Health, University of Manchester, Manchester, UK.
  • Peek N; The National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK; Division of Informatics, Imaging and Data Science, University of Manchester, Manchester, UK.
Lancet Public Health ; 5(10): e543-e550, 2020 10.
Article in English | MEDLINE | ID: covidwho-803320
Semantic information from SemMedBD (by NLM)
1. Diagnosis AFFECTS COVID-19
Subject
Diagnosis
Predicate
AFFECTS
Object
COVID-19
2. Diagnosis DIAGNOSES Disease
Subject
Diagnosis
Predicate
DIAGNOSES
Object
Disease
3. Diagnosis DIAGNOSES Diabetes Mellitu
Subject
Diagnosis
Predicate
DIAGNOSES
Object
Diabetes Mellitu
4. Disease type AND/OR category unknown PROCESS_OF Patients
Subject
Disease type AND/OR category unknown
Predicate
PROCESS_OF
Object
Patients
5. Disease AFFECTS Hydranencephaly with Renal Aplasia-Dysplasia
Subject
Disease
Predicate
AFFECTS
Object
Hydranencephaly with Renal Aplasia-Dysplasia
6. Present PROCESS_OF Patients
Subject
Present
Predicate
PROCESS_OF
Object
Patients
7. Diagnosis AFFECTS COVID-19
Subject
Diagnosis
Predicate
AFFECTS
Object
COVID-19
8. Diagnosis DIAGNOSES Disease
Subject
Diagnosis
Predicate
DIAGNOSES
Object
Disease
9. Diagnosis DIAGNOSES Diabetes Mellitus, Non-Insulin-Dependent
Subject
Diagnosis
Predicate
DIAGNOSES
Object
Diabetes Mellitus, Non-Insulin-Dependent
10. Disease type AND/OR category unknown PROCESS_OF Patients
Subject
Disease type AND/OR category unknown
Predicate
PROCESS_OF
Object
Patients
11. Disease AFFECTS Hydranencephaly with Renal Aplasia-Dysplasia
Subject
Disease
Predicate
AFFECTS
Object
Hydranencephaly with Renal Aplasia-Dysplasia
12. Present PROCESS_OF Patients
Subject
Present
Predicate
PROCESS_OF
Object
Patients
ABSTRACT

BACKGROUND:

To date, research on the indirect impact of the COVID-19 pandemic on the health of the population and the health-care system is scarce. We aimed to investigate the indirect effect of the COVID-19 pandemic on general practice health-care usage, and the subsequent diagnoses of common physical and mental health conditions in a deprived UK population.

METHODS:

We did a retrospective cohort study using routinely collected primary care data that was recorded in the Salford Integrated Record between Jan 1, 2010, and May 31, 2020. We extracted the weekly number of clinical codes entered into patient records overall, and for six high-level categories symptoms and observations, diagnoses, prescriptions, operations and procedures, laboratory tests, and other diagnostic procedures. Negative binomial regression models were applied to monthly counts of first diagnoses of common conditions (common mental health problems, cardiovascular and cerebrovascular disease, type 2 diabetes, and cancer), and corresponding first prescriptions of medications indicative of these conditions. We used these models to predict the expected numbers of first diagnoses and first prescriptions between March 1 and May 31, 2020, which were then compared with the observed numbers for the same time period.

FINDINGS:

Between March 1 and May 31, 2020, 1073 first diagnoses of common mental health problems were reported compared with 2147 expected cases (95% CI 1821 to 2489) based on preceding years, representing a 50·0% reduction (95% CI 41·1 to 56·9). Compared with expected numbers, 456 fewer diagnoses of circulatory system diseases (43·3% reduction, 95% CI 29·6 to 53·5), and 135 fewer type 2 diabetes diagnoses (49·0% reduction, 23·8 to 63·1) were observed. The number of first prescriptions of associated medications was also lower than expected for the same time period. However, the gap between observed and expected cancer diagnoses (31 fewer; 16·0% reduction, -18·1 to 36·6) during this time period was not statistically significant.

INTERPRETATION:

In this deprived urban population, diagnoses of common conditions decreased substantially between March and May 2020, suggesting a large number of patients have undiagnosed conditions. A rebound in future workload could be imminent as COVID-19 restrictions ease and patients with undiagnosed conditions or delayed diagnosis present to primary and secondary health-care services. Such services should prioritise the diagnosis and treatment of these patients to mitigate potential indirect harms to protect public health.

FUNDING:

National Institute of Health Research.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Primary Health Care / Coronavirus Infections / Diagnosis / Pandemics Type of study: Diagnostic study / Etiology study / Observational study / Prognostic study / Risk factors Limits: Adult / Female / Humans / Male / Middle aged / Young adult Country/Region as subject: Europa Language: English Journal: Lancet Public Health Year: 2020 Document Type: Article

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Primary Health Care / Coronavirus Infections / Diagnosis / Pandemics Type of study: Diagnostic study / Etiology study / Observational study / Prognostic study / Risk factors Limits: Adult / Female / Humans / Male / Middle aged / Young adult Country/Region as subject: Europa Language: English Journal: Lancet Public Health Year: 2020 Document Type: Article