P213: Impact of COVID-19 on Preventive Care Services Utilization and Medication Adherence in Diabetes Mellitus Patients
Biomedical Research Program Manager
IBM Watson Health United States
The objective of this study is to understand the impact of COVID-19 pandemic on clinical management of chronic diseases with Diabetes Mellitus (DM) as an example and to understand how COVID-19 has protracted ripple effects on the health footprint beyond the immediate mortality and morbidity.
Insurance claims for DM patients were obtained for the baseline periods in 2018 and 2019 and COVID-19 period in 2020. Rates of pneumococcal vaccination, eye exams for diabetic retinopathy, diabetic nephropathy screening, serum HbA1c testing, and medication (metformin) adherence were analyzed.
In this work we analyzed preventive services utilization and clinical interventions for management of diabetes mellitus (DM) using data from MarketScan, a large insurance claims database. Pneumococcal vaccinations and screening retinopathy and nephropathy declined by 56%, 48% and 42%, respectively, during the pandemic in 2020 compared with 2018 and 2019. Similarly, Serum HbA1c testing decreased by 36% in 2020 pandemic compared to prior years. However, metformin adherence remained unchanged in 2020. To evaluate metformin adherence, medication possession ratio (MPR) was assessed for each of the cohorts. MPR was defined as the sum of the days of medication supply divided by the number of days between first and last prescription. Medication adherence was defined as proportion of patients with an MPR = 80%.
Pandemics, such as COVID-19 have prolonged repercussions on the community health footprint beyond the immediate mortality and morbidity associated with the disease. The protracted ripple effects include delays in guideline directed care, deferred, or neglected care for chronic conditions, psychological trauma, and mental illness. Healthcare resource reallocation and patient hesitancy for in-person preventive care visits upended the management of chronic diseases during COVID-19.
While COVID-19 pandemic significantly affected preventive practices for DM, patients were adherent to medication. These results suggest that patients were hesitant for in person preventive care visits but had access to their medications during the pandemic - presumably a result of a one-time socially distanced prescription pickup or a mail order delivery.