Medication management practices for non-communicable diseases during the second wave of the covid-19 pandemic: a snapshot of the european situation

Objectives: The appropriate management of non-communicable diseases (NCDs) is particularly important during a pandemic;however, the intensive focus on COVID-19 prevention, and the lockdown and physical distancing restrictions affected NCD-related healthcare services adversely. We aimed to evaluate medication management practices for NCDs during the second wave of the COVID-19 pandemic across Europe and assess association with COVID-19 burden and country income. Methods: In December 2020, COST Action ENABLE (CA19132) conducted a cross-sectional, web-based survey in 38 European countries and Israel on available face-to-face and e-health medication management services in place for NCDs. COVID-19 burden was defined as the number of positive cases and deaths per 100,000 inhabitants;country income was assessed as gross domestic product per capita (GDP/capita) at purchasing power parity. Descriptive statistics, nonparametric tests and generalized linear models were applied in this analysis. Results: 53 experts (i.e., healthcare providers and academics with medical or pharmaceutical backgrounds) from 39 countries completed the survey. In 35 (90%) of countries face-to-face consultations were limited and this showed a positive association with the number of COVID-19 cases (p=0.03) and deaths (p=0.05). The mean (SD) number of available e-health services (including e-mail, online chat, phone, videoconference, electronic health record portal or other) was 3 (1.3) and this was positively associated with GDP/capita of countries (p=0.05). There was no further association between the evaluated variables. Conclusions: Although COVID-19 limited the number of face-to-face appointments in NCD care, it accelerated e-health solutions. Reduction in face-to-face consultations was associated with greater burden of COVID-19;however, the uptake of e-health services was associated with higher country income. This suggests significant disparities in maintaining services for NCDs across Europe during the second wave of the pandemic.