Factores sociales y de salud relacionados a la discontinuidad de los tratamientos en adultos chilenos con enfermedades crónicas durante la pandemia por COVID-19

Abstract

A collateral effect of the COVID-19 pandemic has been the discontinuity of treatments, a highly sensitive situation for chronic patients. Aim: to describe the factors associated with discontinuing treatments in chronic patients over 18 years old residing in Chile during the COVID-19 pandemic. Methods: A secondary analysis of the database of the MOVID-IMPACT-C survey, which corresponds to a cross-sectional study with national urban representativeness, was carried out in 2020. Social and health factors were defined as explanatory variables, and treatment discontinuity as a response variable. The proportion of chronic patients who discontinued their treatment, crude and adjusted OR, was estimated using multivariate logistic regression models. Results: 40.42% of chronic patients discontinued their treatments. Those whose last consultation was at the “tertiary” level (OR= 0.58) or at the “emergency” level (OR= 0.14) were less likely to have discontinued treatment than those who attended at the “primary” level, independently of the provider (public/private). Chronic patients whose pre-existing health was diabetes were more likely to have discontinued treatment (OR= 1.57). In addition, a strong association was observed between those who discontinued their treatments and perceived worsening of their health status (OR= 2.25). Conclusions: A high discontinuity of treatment was observed during the COVID-19 pandemic in chronic patients in Chile, with hypertensive patients being the most affected and patients with diabetes the most likely to be disrupted. It was observed that patients under control due to major cardiovascular events were the ones who discontinued their treatments the least, which may be indicative of a good response from the system in prioritizing patients with greater severity or emergency.