The Impact of the COVID-19 Pandemic on Self-Reported Outcomes in Patients With Adrenal Insufficiency.
The Impact of the COVID-19 Pandemic on Self-Reported Outcomes in Patients With Adrenal Insufficiency.
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DOI：
10.1210/clinem/dgab334
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发表时间：
2021-06-16
期刊：
影响因子：
--
通讯作者：
Bancos I
中科院分区：
文献类型：
--
作者：
Li D;Suresh M;Abbondanza T;Vaidya A;Bancos I
COVID-19大流行对医疗保健环境造成了影响。确定大流行对肾上腺功能不全（AI）患者自我报告结局的影响。两个高等教育中心的前瞻性纵向调查研究。人工智能患者。以病人为中心的问卷。抑郁，焦虑，压力量表-21，简短表格-36，以及人工智能自我管理。在342例患者中，157例（46%）为原发性AI， 109例（32%）为继发性AI， 76例（22%）为糖皮质激素诱导的AI。与大流行前相比，每日糖皮质激素剂量和肾上腺危机次数没有变化。然而，患者报告说，在大流行期间，人工智能对经济的影响更大（34%对23%，P = 0.006），难以获得医疗服务（31%对7%，P < 0.0001）。三分之一的患者报告在大流行期间难以管理人工智能。在调整了AI的持续时间和亚型后，年轻患者[比值比（OR） 2.3, CI 95% 1.3-4.1]、女性（OR 3.7, CI 95% 1.9-7.1）、较差的医疗保健机会（OR 4.2, CI 95% 2.3-7.7）、缺乏良好的保险支持（OR 2.8, CI 95% 1.3-5.9）和经济影响较大的患者（OR 2.3, CI 95% 1.3-4.3）报告了更大的AI管理困难。如果患者在大流行期间发现管理人工智能具有挑战性（OR 3.0, CI 95% 1.3-6.9），则他们更有可能报告更高的焦虑评分（≥8），并且在大流行之前，他们的身体成分总结（OR 4.9, CI 95% 2.2-11.0）和精神成分总结（OR 4.1, CI 95% 1.8-9.5）得分较低。三分之一的人工智能患者报告在大流行期间难以管理人工智能，特别是年轻患者、妇女和医疗保健机会较差的患者。
The COVID-19 pandemic has impacted healthcare environment. To determine the impact of the pandemic on self-reported outcomes in patients with adrenal insufficiency (AI). Prospective longitudinal survey study at 2 tertiary centers. Patients with AI. Patient-centered questionnaire. Depression Anxiety Stress Scales-21, Short Form-36, and AI self-management. 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%, P = 0.006) and difficulty accessing medical care (31% vs 7%, P < 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. 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.
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