Impact of the COVID-19 pandemic on medication adherence and access to care among people with chronic diseases: a cross-sectional online survey

Beatriz Santos, Younes Boulaguiem, Helene Baysson, Nick Pullen, Idris Guessous, Stephane Guerrier, Silvia Stringhini and Marie P. Schneider.
Patient-Perceived Impact of the COVID-19 Pandemic on Medication Adherence and Access to Care for Long-Term Diseases: A Cross-Sectional Online SurveyCOVID 2024, 4, 191-207. February 2024, doi.org/10.3390/covid4020015

Abstract

Background: The COVID-19 pandemic has been associated with lifestyle changes, reduced access to care and potential impacts on medication self-management. Our main objectives were to assess the impact of the pandemic on medication adherence and access to care among people with chronic diseases and to determine their association with sociodemographic and clinical factors.

Methods: This survey is part of the Specchio-COVID-19 longitudinal cohort study conducted in Geneva, Switzerland, using online questionnaires on the Specchio-Hub platform (www.specchio-hub.ch). The eligible population for this survey was made up of adult participants who had reported having at least one long-term chronic disease in the Specchio-Covid19 inclusion questionnaire (n = 2,788). A specific questionnaire on the impact of the COVID-19 pandemic on adherence to treatment and access to care was sent to them in September 2021.

Results: 1,549 participants completed the questionnaire (55% response rate), and 1,048 confirmed that they had at least one long-term illness. Of the 982 participants included in the analysis (median age: 56; 61% women), 827 were taking long-term medication. 76 changes in drug dosage were reported, including 24 (31%) without a doctor's recommendation, and 51 delays in initiation or premature discontinuation of treatment, including 24 (47%) without a doctor's recommendation. Only 1% (9/827) of participants experienced problems accessing medication. The prevalence of people with chronic diseases reporting a change in their medication intake during the COVID-19 pandemic was significantly lower in our study than in studies conducted in the United States, but similar to other studies conducted in Europe. Older people and those with a higher level of education were less likely to have their medication intake affected by the pandemic, which is consistent with other studies. People taking respiratory medication were four times more likely to report taking their medication more regularly (OR = 4.27; 95% CI: 2.11-8.63).

Conclusion: This study shows that the pandemic had a limited perceived impact on medication adherence among people with long-term chronic illnesses. Access to long-term medication was ensured by measures such as semi-confinement - which did not prevent individuals from leaving their homes - as well as changes in healthcare use (such as telehealth) - and prescription refills by community pharmacists.

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