Association between the reduction of face-to-face appointments and the control of patients with type 2 diabetes mellitus during the Covid-19 pandemic in Catalonia

Abstract

AimTo analyse the relation between face-to-face appointments and management of patients with type 2 diabetes mellitus (T2DM) visited in primary care practices (PCP). MethodsRetrospective study in 287 primary care practices (PCPs) attending>300,000 patients with T2DM. We analysed the results of 9 diabetes-related indicators of the Healthcare quality standard, comprising foot and retinopathy screening, blood pressure (BP) and glycemic control; and the incidence of T2DM. We calculated each indicator’s percentage of change in 2020 with respect to the results of 2019. ResultsIndicators’ results were reduced in 2020 compared to 2019, highlighting the indicators of foot and retinopathy screening (-51.6% and −25.7%, respectively); the glycemic control indicator (-21.2%); the BP control indicator (–33.7%) and the incidence of T2DM (-25.6%). Conversely, the percentage of type 2 diabetes patients with HbA1c > 10% increased by 34%.PCPs with<11 weekly face-to-face appointments offered per professional had greater reductions than those PCPs with more than 40. For instance, a reduction of −60.7% vs −38.2% (p-value < 0.001) in the foot screening’s indicator; −27.5% vs −12.5% (p-value < 0.001) in glycemic control and −40.2 vs −24.3% (p-value < 0.001) in BP control. ConclusionsReducing face-to-face visits offered may impact T2DM patients’ follow-up and thus worsen their control.