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Table 2 Impact of COVID-19 pandemic on health, healthcare access, treatment satisfaction and achievement of care goals

From: Health, psychosocial, and economic impacts of the COVID-19 pandemic on people with chronic conditions in India: a mixed methods study

  Overall (N = 1734) Delhi (N = 430) Chennai (N = 494) Sonipat (N = 410) Vizag (N = 400) p-value*
Rural (N = 209) Urban (N = 201) Rural (N = 192) Urban (N = 208)
Experienced acute medical illness during the COVID-19 lockdown 142 (8.2%) 25 (5.8%) 25 (5.1%) 31 (14.8%) 11 (5.5%) 26 (13.5%) 24 (11.5%) < 0.001
Difficulty in accessing healthcare facility during COVID-19 lockdown 118 (83.1) 20 (80) 16 (64) 31 (100) 8 (72.7) 23 (88.5) 20 (83.3) 0.014
Experienced difficulties in accessing medicines due to COVID-19 situation 293 (16.9%) 27 (6.3%) 47 (9.5%) 69 (33.0%) 15 (7.5%) 79 (41.1%) 56 (26.9%)  
 Diabetes mellitus 134 (18.0%) 17 (9.4%) 36 (14.1%) 11 (31.4%) 7 (8.0%) 24 (49.0%) 39 (28.7%) 0.24
 Hypertension 198 (20.3%) 13 (6.4%) 20 (9.5%) 53 (34.4%) 11 (10.6%) 60 (39.5%) 41 (26.8%) < 0.001
 Cardiovascular disease 35 (15.3%) 1 (2%) 7 (18%) 16 (28%) 0 (0%) 4 (20%) 7 (22%) 0.002
 Chronic kidney disease 7 (16%) 2 (22%) 1 (17%) 3 (25%) 0 (0%) 0 (0%) 1 (14%) 0.59
 COPD 2 (11%) 0 (0%) 1 (50%) 1 (50%) 0 (0%) 0 (0%) 0 (0%) 0.22
Experienced difficulties in accessing medicines or treatment due to financial reasons 258 (14.9%) 16 (3.7%) 58 (11.7%) 36 (17.2%) 10 (5.0%) 88 (45.8%) 50 (24.0%)  
 Diabetes mellitus 124 (16.7%) 12 (6.7%) 44 (17.3%) 7 (20.0%) 4 (4.5%) 23 (46.9%) 34 (25.0%) 0.75
 Hypertension 162 (16.6%) 7 (3.5%) 28 (13.3%) 21 (13.6%) 7 (6.7%) 70 (46.1%) 29 (19.0%) 0.004
 Cardiovascular disease 25 (10.9%) 0 (0%) 3 (8%) 9 (16%) 0 (0%) 5 (25%) 8 (25%) 0.10
 Chronic kidney disease 4 (9%) 1 (11%) 0 (0%) 2 (17%) 0 (0%) 0 (0%) 1 (14%) 0.52
Chronic obstructive pulmonary lung disease 2 (11%) 0 (0%) 0 (0%) 1 (50%) 0 (0%) 0 (0%) 1 (20%)  
Functioning local health clinic/hospital during lockdown 1175 (67.8%) 329 (76.5%) 337 (68.2%) 153 (73.2%) 159 (79.1%) 91 (47.4%) 106 (51.0%) < 0.001
Treatment satisfaction during lockdown 331 (19.1%) 96 (22.3%) 181 (36.6%) 3 (1.4%) 24 (11.9%) 11 (5.7%) 16 (7.7%)  
Generalized anxiety disorder scale
 Minimal anxiety 1497 (86.3%) 403 (93.7%) 451 (91.3%) 196 (93.8%) 194 (96.5%) 115 (59.9%) 138 (66.3%) < 0.001
 Mild anxiety 181 (10.4%) 25 (5.8%) 38 (7.7%) 11 (5.3%) 7 (3.5%) 60 (31.3%) 40 (19.2%)  
 Moderate anxiety 34 (2.0%) 1 (0.2%) 4 (0.8%) 1 (0.5%) 0 (0.0%) 10 (5.2%) 18 (8.7%)  
 Severe anxiety 22 (1.3%) 1 (0.2%) 1 (0.2%) 1 (0.5%) 0 (0.0%) 7 (3.6%) 12 (5.8%)  
Overall health status score (EQ-VAS), mean (SD) 76.1 (15.3) (n = 1734) 77.1 (16.5) 78.4 (15.7) 78.4 (15.6) 72.7 (16.3) 71.1 (11.1) 74.0 (11.7) < 0.001
 Mobility (moderate/severe problems) 360 (20.8%) 91 (21.2%) 78 (15.8%) 60 (28.7%) 58 (28.9%) 45 (23.4%) 28 (13.5%)  
 Self-care (moderate/severe problems) 136 (7.8%) 23 (5.3%) 41 (8.3%) 16 (7.7%) 29 (14.4%) 14 (7.3%) 13 (6.3%)  
 Usual care (moderate/severe problems) 223 (12.9%) 31 (7.2%) 59 (11.9%) 38 (18.2%) 39 (19.4%) 29 (15.1%) 27 (13.0%)  
 Pain/discomfort (moderate/severe problems) 448 (25.8%) 135 (31.4%) 70 (14.2%) 79 (37.8%) 70 (34.8%) 56 (29.2%) 38 (18.3%)  
 Anxiety/depression (moderate/severe problems) 314 (18.1%) 58 (13.5%) 83 (16.8%) 46 (22.0%) 41 (20.4%) 51 (26.6%) 35 (16.8%)  
Health consequences in people with diabetes (N) 743 180 255 35 88 49 136  
 Fasting blood sugar tested during the lockdown 414 (55.7%) 130 (72.2%) 151 (59.2%) 13 (37.1%) 37 (42.0%) 17 (34.7%) 66 (48.5%) < 0.001
 HbA1c tested during the lockdown 35 (4.7%) 10 (5.6%) 8 (3.1%) 0 (0.0%) 4 (4.5%) 0 (0.0%) 13 (9.6%) < 0.001
 Fasting blood sugar, mean (SD) 166.6 (71.8) 158.0 (64.5) 185.9 (83.1) 287.3 (83.6) 137.4 (32.1) 197.1 (63.4) 139.7 (44.2) < 0.001
 Fasting blood sugar > 160–200 mg/dl 51 (17.9) 19 (16.2) 18 (19.6) 1 (16.7) 3 (30) 3 (42.9) 7 (13.2)  
 Fasting blood sugar > 200 mg/dl 55 (19.3) 17 (14.5) 29 (31.5) 5 (83.3) 0 (0) 2 (28.6) 2 (3.8)  
 Blood sugar controlled (perceived) 230 (31.0%) 35 (19.4%) 87 (34.1%) 16 (45.7%) 19 (21.6%) 27 (55.1%) 46 (33.8%) < 0.001
 Diabetes symptoms worsened during the lockdown 97 (13.1%) 33 (18.3%) 23 (9.0%) 8 (22.9%) 9 (10.2%) 8 (16.3%) 16 (11.8%) < 0.001
 Glucose monitoring frequency at home
  Once in month 83 (11.2%) 43 (23.9%) 13 (5.1%) 2 (5.7%) 16 (18.2%) 1 (2.0%) 8 (5.9%)  
  Do not monitor glucose at home 530 (71.3%) 70 (38.9%) 223 (87.5%) 33 (94.3%) 62 (70.5%) 46 (93.9%) 96 (70.6%)  
Health consequences in people with hypertension (N) 975 202 210 154 104 152 153  
 Blood pressure measured during the lockdown 515 (52.8%) 137 (67.8%) 127 (60.5%) 70 (45.5%) 39 (37.5%) 53 (34.9%) 89 (58.2%) < 0.001
 Systolic blood pressure, mean (SD) 139.0 (20.3) 142.5 (18.8) 135.4 (19.4) 152.2 (29.7) 140.3 (19.2) 133.3 (19.5) 132.2 (14.2) < 0.001
 Diastolic blood pressure, mean (SD) 86.9 (13.5) 88.7 (11.1) 84.6 (11.0) 91.8 (25.9) 85.8 (17.0) 84.8 (11.3) 84.6 (7.1) 0.042
 SBP ≤140 mmHg 271 (74.6%) 79 (69.9%) 38 (67.9%) 22 (56.4%) 27 (75.0%) 25 (86.2%) 80 (88.9%) 0.008
 SBP > 140–160 mmHg 57 (15.7%) 19 (16.8%) 12 (21.4%) 9 (23.1%) 6 (16.7%) 3 (10.3%) 8 (8.9%)  
 SBP > 160 mmHg 35 (9.6%) 15 (13.3%) 6 (10.7%) 8 (20.5%) 3 (8.3%) 1 (3.4%) 2 (2.2%)  
 Blood pressure controlled (perceived) 142 (14.6%) 18 (8.9%) 65 (31.0%) 24 (15.6%) 5 (4.8%) 21 (13.8%) 9 (5.9%) 0.022
 Symptoms of hypertension worsened during the lockdown 120 (12.3%) 42 (20.8%) 6 (2.9%) 38 (24.7%) 8 (7.7%) 13 (8.6%) 13 (8.5%) < 0.001
  1. Diabetes is defined based on fasting plasma glucose (FPG) > =126 mg/dl (7.0 mmol/l) and/or glycated haemoglobin (HbA1c) > = 6.5% (48 mmol/mol) or self-reported or on anti-diabetic medications. Hypertension was defined as being on antihypertensive medications or a systolic blood pressure > =140 mmHg and/or a diastolic blood pressure > =90 mmHg. Cardiovascular disease and chronic kidney disease were self-reported and/or on medications
  2. HbA1c glycated haemoglobin, COPD chronic obstructive pulmonary lung disease, EQ-VAS European Quality of Life 5-dimension, Visual analogue scale, SBP systolic blood pressure, DBP diastolic blood pressure, SD standard deviation, INR Indian rupees, COVID-19 coronavirus disease 2019, mmHg millimoles of mercury
  3. *p value reported for between group difference across study sites