Physician visits and medication prescriptions for major chronic diseases during the COVID-19 pandemic in Japan: retrospective cohort study.
Physician visits and medication prescriptions for major chronic diseases during the COVID-19 pandemic in Japan: retrospective cohort study.
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DOI：
10.1136/bmjopen-2021-050938
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发表时间：
2021-07-23
期刊：
影响因子：
2.9
通讯作者：
Tsugawa Y
中科院分区：
文献类型：
--
作者：
Osawa I;Goto T;Asami Y;Itoh N;Kaga Y;Yamamoto Y;Tsugawa Y
有人担心，慢性病患者可能会因为害怕COVID-19而避免亲自去看医生，导致护理质量下降。我们旨在调查COVID-19大流行之前和期间在人群水平上慢性病的医生就诊和药物处方的变化。回顾性队列研究。2018-2020年日本全国索赔数据。在大流行病爆发前曾因主要慢性病（高血压、糖尿病和血脂异常）就医并得到处方的工作年龄人口（18-74岁）。结果为大流行期间（2020年4月至5月，因2019冠状病毒病首次紧急状态于4月7日宣布，并于5月25日在全国范围内撤销）的每月医生就诊次数、每月医生就诊比例和每月处方药覆盖天数比例。在10346名在大流行前因慢性病就诊的患者中，我们发现医生就诊次数暂时下降（3月平均就诊次数为1.9次，4月为1.7次; p<0.001），而在大流行期间没有就诊的患者比例增加（3月为15%，4月为24%; p<0.001）。5月，医生访视恢复到基线水平（平均访视次数：1.8，未访视任何医生的患者比例：9%）。我们观察到大流行之前和期间的PDC没有临床意义的差异（例如，3月为87%，4月为87%; p=0.45）。与其他地区相比，在COVID-19病例数量较多的七个县，医生访问量的暂时下降更为明显。尽管在COVID-19爆发后，医生的就诊次数立即下降，但一个月后恢复到基线水平;患者在大流行期间没有跳过药物。
There have been concerns that patients with chronic conditions may be avoiding in-person physician visits due to fear of COVID-19, leading to lower quality of care. We aimed to investigate changes in physician visits and medication prescriptions for chronic diseases before and during the COVID-19 pandemic at the population level. Retrospective cohort study. Nationwide claims data in Japan, 2018–2020. Working-age population (aged 18–74 years) who visited physicians and received any prescriptions for major chronic diseases (hypertension, diabetes and dyslipidaemia) before the pandemic. The outcomes were the monthly number of physician visits, the monthly proportion of physician visits and the monthly proportion of days covered by prescribed medication (PDC) during the pandemic (April–May 2020, as the first state of emergency over COVID-19 was declared on 7 April, and withdrawn nationally on 25 May). Among 10 346 patients who visited physicians for chronic diseases before the pandemic, we found a temporary decline in physician visits (mean number of visits was 1.9 in March vs 1.7 in April; p<0.001) and an increase in the proportion of patients who did not visit any physicians during the pandemic (15% in March vs 24% in April; p<0.001). Physician visits returned to the baseline in May (the mean number of visits: 1.8, and the proportion of patients who did not visit any physicians: 9%). We observed no clinically meaningful difference in PDC between before and during the pandemic (eg, 87% in March vs 87% in April; p=0.45). A temporary decline in physician visits was more salient in seven prefectures with a larger number of COVID-19 cases than in other areas. Although the number of physician visits declined right after the COVID-19 outbreak, it returned to the baseline one month later; patients were not skipping medications during the pandemic.
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影响因子：
4.6
作者：
Song Y;Liu X;Zhu X;Zhao B;Hu B;Sheng X;Chen L;Yu M;Yang T;Zhao J
通讯作者：
Zhao J
DOI：
10.1161/hypertensionaha.118.11499
发表时间：
2018-10
期刊：
Hypertension (Dallas, Tex. : 1979)
影响因子：
--
作者：
Pierdomenico SD;Pierdomenico AM;Coccina F;Clement DL;De Buyzere ML;De Bacquer DA;Ben-Dov IZ;Vongpatanasin W;Banegas JR;Ruilope LM;Thijs L;Staessen JA
通讯作者：
Staessen JA
影响因子：
--
作者：
Martini, Nello;Piccinni, Carlo;Maggioni, Aldo
通讯作者：
Maggioni, Aldo
中国武汉市 138 例 2019 新型冠状病毒感染肺炎住院患者的临床特征。
影响因子：
120.7
作者：
Wang, Dawei;Hu, Bo;Peng, Zhiyong
通讯作者：
Peng, Zhiyong
影响因子：
13.8
作者：
Baum, Aaron;Barnett, Michael L.;Schwartz, Mark D.
通讯作者：
Schwartz, Mark D.