PROVIDENCE, R.I., July 23,
2024 /PRNewswire/ -- The latest issue of Annals of
Family Medicine features three important studies shedding
light on various aspects of COVID-19, from potential treatment to
the prevalence of post-COVID conditions to the impact on primary
care and telehealth utilization. These studies offer critical
insights for health care professionals and policymakers as they
navigate the ongoing challenges posed by the pandemic.
Study 1: National Study Shows Moderate Burden of Post-COVID
Conditions in Primary Care
This study was conducted by researchers from Stanford University, the CDC, the American Board of
Family Medicine Foundation, and the Institute for Healthcare Policy
and Innovation at the University of
Michigan. Titled "Post-COVID Conditions in US Primary Care:
A PRIME Registry Comparison of Patients With COVID-19,
Influenza-Like Illness, and Wellness Visits," the study examined
the prevalence of post-COVID conditions among adult patients
diagnosed with COVID-19, comparing them to those with
influenza-like illness and those who had regular wellness visits
but no COVID-19. The American Family Cohort, a unique and
geographically diverse research dataset derived from the American
Board of Family Medicine's PRIME Registry, was used to examine data
from the years 2018 to 2021.
Main Results:
- Patients with COVID-19 had a higher prevalence of breathing
difficulties, type 2 diabetes, fatigue, and sleep disturbances
compared to those with influenza-like illness. However, all
prevalence differences were less than 3%.
- There were no significant differences in the monthly increase
of new health conditions between patients with COVID-19 and those
with influenza-like illness.
- Patients with COVID-19 had a higher prevalence of breathing
difficulties and type 2 diabetes compared to patients who had
regular wellness visits but did not contract COVID-19.
Understanding the types and prevalence of post-COVID conditions
helps health care professionals diagnose and treat these conditions
more effectively, potentially reducing long-term health issues and
improving patient care.
Study 2: Nirmatrelvir/Ritonavir Shows Potential in Reducing
COVID-19 Hospitalizations
The systematic review, titled "Nirmatrelvir/Ritonavir Regimen
for Mild/Moderately Severe COVID-19: A Rapid Review With
Meta-Analysis and Trial Sequential Analysis," aimed to evaluate the
efficacy, effectiveness, and safety of the antiviral drug
combination nirmatrelvir/ritonavir for treating mild to moderately
severe COVID-19 in non-hospitalized patients at risk of worsening
symptoms, hospitalization, and death. Researchers examined both
randomized controlled trials and real-world observational
studies.
Main Results:
- Randomized Controlled Trials and Real-World Studies:
Nirmatrelvir/ritonavir significantly reduced hospitalizations.
- Real-World Studies: Nirmatrelvir/ritonavir significantly
reduced all-cause mortality.
- Randomized Controlled Trials: There were no significant
differences in reducing worsening severity, viral clearance,
adverse events, serious adverse events, or all-cause mortality,
although trial sequential analysis suggested that the current total
sample sizes for these outcomes were not enough for conclusions to
be drawn.
The nirmatrelvir/ritonavir regimen reduced COVID-19
hospitalizations with mild to moderately severe COVID-19. The data
on all-cause mortality and other secondary outcomes is mixed.
Study 3: Pandemic's Impact on Primary Care: Significant Drop
in Visits and Uneven Telehealth Use Across Patient Groups
This study, titled "The Disproportionate Impact of Primary Care
Disruption and Telehealth Utilization During COVID-19,"aimed to
quantify the nationwide decline in primary care visits and the
increase in telehealth utilization and explore the impact on
different patient groups. Primary care electronic health record
data from the American Family Cohort was used to examine three
outcomes from March 2019 to
March 2021. Researchers looked at the
percentage change in total visit volume, change in in-person visit
volume, and telehealth conversion ratio (how much care was
delivered via telehealth, defined as the number of pandemic
telehealth visits divided by the total number of pre-pandemic
visits).
Main Results:
- The primary sample included 1,652,871 patients with 8,833,434
visits from 408 practices and 2,328 clinicians.
- During the pandemic, decreases of 7% in total and 17% in
in-person visit volume were observed, as well as a 10% telehealth
conversion ratio (defined as the number of pandemic telehealth
visits divided by the total number of prepandemic visits)
- Pediatric and Asian patients, as well as those with
comorbidities, experienced the largest declines in visit volume,
while telehealth usage was highest among Hispanic patients and
those in urban areas.
These findings underscore the need to enhance telehealth
infrastructure and address barriers in rural and underserved areas
to ensure equitable access to care during future disruptions. The
findings also emphasize the importance of maintaining primary care
access during future disruptions to prevent long-term health
consequences and exacerbation of existing health care
disparities.
Articles Cited:
Nirmatrelvir/Ritonavir Regimen for Mild/Moderately Severe
COVID-19: A Rapid Review With Meta-Analysis and Trial Sequential
Analysis
George N. Okoli, MD, PhD,
Nicole Askin, MLIS, Rasheda Rabbani, PhD
Post-COVID Conditions in US Primary Care: A PRIME Registry
Comparison of Patients With COVID-19, Influenza-Like Illness, and
Wellness Visits
Esther E. Velásquez, ScD, Neil S. Kamdar, MA, David H. Rehkopf, ScD, Sharon Saydah, PhD, MHS, Lara Bull-Otterson, PhD, MPH, Shiying Hao, PhD, Ayin Vala, MS, Isabella Chu, MPH, Andrew W. Bazemore, MD, MPH, Robert L. Phillips, MD, MSPH, Tegan Boehmer, PhD, MPH
The Disproportionate Impact of Primary Care Disruption and
Telehealth Utilization During COVID-19
Zachary J. Morgan, MS, Andrew W. Bazemore, MD, MPH, Lars E. Peterson, MD, PhD, Robert L. Phillips, Jr, MD, MSPH, Mingliang Dai, PhD
Annals of Family Medicine is a peer-reviewed, indexed
research journal that provides a cross-disciplinary forum for new,
evidence-based information affecting the primary care disciplines.
Launched in May 2003, Annals of
Family Medicine is sponsored by seven family medical
organizations, including the American Academy of Family Physicians,
the American Board of Family Medicine, the Society of Teachers of
Family Medicine, the Association of Departments of Family Medicine,
the Association of Family Medicine Residency Directors, the North
American Primary Care Research Group, and the College of Family
Physicians of Canada. Annals of
Family Medicine is published online six times each year and
contains original research from the clinical, biomedical, social,
and health services areas, as well as contributions on methodology
and theory, selected reviews, essays, and editorials. Complete
editorial content and interactive discussion groups for each
published article can be accessed for free on the journal's
website, www.AnnFamMed.org.
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SOURCE Annals of Family Medicine