Abstract P153: Disruptions to Diabetes and Hypertension Care During the COVID-19 Pandemic and Recovery Approaches in the Latin America and Caribbean Region

Abstract

Background: The COVID-19 pandemic disrupted healthcare services in Latin America and the Caribbean (LAC). However, few studies provided comprehensive and quantitative data on the magnitude of this disruption. Objectives: To synthesize evidence on the extent of disruptions to diabetes and hypertension care in LAC during the COVID-19 pandemic and interventions to recover. Methods: We conducted a scoping review of published papers in English, Spanish, and Portuguese. We adopted the Primary Health Care Performance Initiative (PHCPI) Framework to identify healthcare services susceptible to disruptions during the COVID-19 pandemic, specific to diabetes and hypertension, including recovery approaches. We synthesized study findings narratively to represent the diversity of findings geographically and health system. Results: Our search yielded 33,510 abstracts after de-duplication; following title/abstract screening and full-text review, 330 articles (218 on disruptions; 112 on interventions) were included in the synthesis. Although there was high heterogeneity, similarities in landscape of disruptions to primary care services across LAC exist. Of the PHCPI Framework domains, disruptions to workforce, medications and supplies, and patient-related outcomes were most recurrent. Intervention studies focused telehealth using digital strategies for diverse care areas and counseling support for health behaviors and mental health. There were data gaps within LAC regarding health system readiness and digital health effectiveness, adoption, efficiency, reach, and sustainability ( Figure ). Conclusions: This scoping review identified priorities for action within LAC: 1) establish and fund high-quality research and surveillance systems for hypertension and diabetes; 2) Optimally integrate digital health into hypertension and diabetes care; 3) implement mental health promotion strategies among healthcare workers; 4) establish optimal governance, leadership, and financing of healthcare systems.