Abstract
While most of the studies to date demonstrate the deleterious effect of multiple chronic diseases on COVID-19 risk and outcome, there is sparse information available on the effect of the pandemic on multimorbidity management, with no reports yet from India. We sought to explore the effect of COVID-19 pandemic on routine and emergency care for multimorbidity among community-dwelling adults in Odisha, India. A community-based cross-sectional study was undertaken pandemic lockdown, in Khurda district of Odisha, India. Around 600 individuals having at least one chronic disease residing in rural, urban residential and slums were interviewed using a specifically developed questionnaire MAQ COVID-19. The association of socio-demographic characteristics and multimorbidity with pandemic-related care challenges was examined by multiple logistic regression. Principal Component Analysis was employed to minimize the dimensionality of factors related to multimorbidity care. Multimorbidity was highly prevalent in younger age group (46–60 years) with cardio-metabolic clusters being dominant. Individuals with multimorbidity experienced significantly higher care challenges than those with single condition (AOR = 1.48, 95% CI = 1.01–2.05) with notable disruption in treatment and routine check-up. Most frequently cited concerns were—physician consultation (43%), diagnostic-services (26%), transport (33%), and mobility restrictions (21%). Multivariate analysis revealed older adults living alone in urban residence to have higher challenges than their rural counterparts. Patient activation for self-care, multimorbidity literacy, and technology-enabled tele-consultation could be explored as potential interventions. Future studies should qualitatively explore the challenges of physicians as well as garner an in-depth understanding of multimorbidity management in the vulnerable subgroups.
Highlights
The emergence and spread of the COVID-19 has resulted in a public health event of widespread concern across the globe in 2020, with the World Health Organization (WHO) declaring COVID-19 a pandemic in March 2020 [1, 2]
We developed a structured questionnaire— Multimorbidity Assessment Questionnaire during COVID-19 (MAQ-COVID19) for data collection (Appendix II in Supplementary Material)
Individuals with multimorbidity were 48% more likely to report significantly higher care challenges than those who had single morbidity (AOR = 1.48, 95% Confidence interval (CI) = 1.01–2.05)
Summary
The emergence and spread of the COVID-19 has resulted in a public health event of widespread concern across the globe in 2020, with the WHO declaring COVID-19 a pandemic in March 2020 [1, 2]. Multimorbidity Care During COVID-19 registered the first confirmed case of COVID-19 in January 2020, and more than 8,000 confirmed cases, with almost 200 reported deaths as of May 2020 [5]. With an aim to curtail the spread, the nationwide lockdown (1st phase) began from March 24th to May 31st, 2020 in India [6, 7]. Mostly observational, suggest that individuals with major underlying diseases like chronic kidney disease (CKD), cardiovascular disease (CVD), hypertension (HTN), diabetes, chronic obstructive pulmonary disease (COPD), and malignancy have heightened risk of adverse outcome than their counterparts without any pre-existing disease. Recent data reveal that the presence of two or more conditions (multimorbidity) accentuate the outcomes in COVID-19 with around 10-fold risk [8,9,10]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
