Non-Communicable Diseases: Challenges and Impact of COVID-19 Pandemic
Keywords:
Non-communicable diseases, COVID-19, NCDs, underdiagnosis, undertreatment
Abstract
Non-communicable diseases (NCDs) are the major cause of mortality and morbidity worldwide. In India, more than 2/3rd of the total deaths are reported due to NCDs in the World Health Organisation (WHO) South-East Asia Region. Since after the outbreak of COVID-19, as per WHO, 122 countries reported disruptions in NCD health services. NCDs remain undiagnosed due to lack of knowledge and inadequate access to health care. Role of primary care and family physicians can help in early detection and protection against NCD; patient education plays a crucial role in raising awareness of NCDs and their effect on wellbeing. Undertreatment of NCD has become a serious public health issue. Many factors like expenditure for service structure, lack of skilled health workers, periodic review and follow-ups, limited access to essential medicines lead to undertreatment of NCDs. For successful management of NCDs, a multi-disciplinary approach is required that involves adequate knowledge of the disease, adherence to the treatment regimen, follow-ups. People living with NCDs are impacted by COVID-19 pandemic like a disruption in health care services, mental health disorder, reduced physical activities. Many strategies like telemedicine, triaging, the novel supply chain for NCD medicines, and redirection of patients with NCDs to alternate health care facilities are direly needed to be deployed to overcome disruptions in LMICs.
References
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pdf
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2. World health organization. Non-communicable diseases in the South-East Asia region: Situation and response 2011. New Delhi, India: World health organization regional office for South-East Asia; 2011.
3. Nethan S, Sinha D, Mehrotra R. Non communicable disease risk factors and their trends in India. Asian Pacific journal of cancer prevention: APJCP. 2017;18(7):2005.
4. Bogoch II, Watts A, Thomas-Bachli A, Huber C, Kraemer MU, Khan K. Potential for global spread of a novel coronavirus from China. Journal of travel medicine. 2020 January 27.
5. Coronavirus Disease (COVID-19) Dashboard [Internet]. covid19. who.int [cited 2020 September 16]. Available from: https://covid19.who.int/
6. Sun P, Lu X, Xu C, Sun W, Pan B. Understanding of COVID‐19 based on current evidence. Journal of Medical Virology. 2020 February 25.
7. Rapid assessment of service delivery for NCDs during the COVID-19 pandemic: WHO, June 2020 [Internet]. [cited 2020 September 16]. Available from: file:///C:/Users/THD/ Downloads/for-web---rapid-assessment---30-june-2020- (cleared).pdf
8. WHO. Indrayan A. Forecasting vascular disease and associated mortality in India. Burden of Disease in India. National Commission on Macroeconomics and Health. New Delhi: Ministry of Health and Family Welfare, Government of India, 2015.
9. Seigel KR, Patel SA, Ali MK. Non-communicable diseases in South Asia: contemporary perspectives. Br Med Bull 2014; 111: 31–44.
10. Vijay Viswanathan, V Narayan Rao. Problems associated with diabetes care in India. Diabetes Manage. (2013) 3(1), 31– 40
11. Joshi SR, Saboo B, Vadivale M, Dani SI, Mithal A, Kaul U, et al. Prevalence of diagnosed and undiagnosed diabetes and hypertension in India—results from the Screening India’s Twin Epidemic (SITE) study. Diabetes technology & therapeutics. 2012 Jan 1;14(1):8-15.
12. Raheja BS, Kapur A, Bhoraskar A, Sathe SR, Jorgensen LN, Moorthi SR, et al. Diabcare Asia- India Study:Diabetes care in India – current status. J Assoc Phys India. 2001;49:717–22.
13. Bjork S, Kapur A, King H, Nair J, Ramachandran A. Global policy:aspects of diabetes in India. Health Policy. 2003;66:61– 72.
14. Nagpal J, Bhartia A. Quality of diabetes care in the middle- and high-income group populace – the Delhi Diabetes Community (DEDICOM) survey. Diabetes Care. 2006;29:2341–8.
15. Deepa M, Deepa R, Shanthirani CS, Dutta M, Unwin NC, Kapur A, et al. awareness and knowledge of diabetes in Chennai – the Chennai Urban Rural Epidemiology Study (CURES.-9) J Assoc Phys India. 2005;53:283–7.
16. Farag YM, Mittal BV, Keithi-Reddy SR, Acharya VN, Almeida AF, Anil C, et al. Burden and predictors of hypertension in India: results of SEEK (Screening and Early Evaluation of Kidney Disease) study. BMC nephrology. 2014 Dec 1;15(1):42.
17. Zhong N, Wang C, Yao W, Chen P, Kang J, Huang S, et al. Prevalence of chronic obstructive pulmonary disease in China: a large, population-based survey. Am J Respir Crit Care Med 2007;176:753–760.
18. Kotwani A. Access to essential medicines and standard treatment for chronic diseases. Indian Journal of Pharmacology. 2010 Jun;42(3):127.
19. Sinha R, Pati S. Addressing the escalating burden of chronic diseases in India: Need for strengthening primary care. Journal of Family Medicine and Primary Care. 2017 Oct;6(4):701.
20. Price, availability and affordability. An international comparison of chronic disease medicines [Internet]. [cited 2020 September 01]. Available from: https://haiweb.org/wp-content/ uploads/2015/08/Price-Availability-Affordability-An- International-Comparison-of-Chronic-Disease-Medicines. pdf
21. National List of Essential Medicines. Government of India. 2003.
22. Chow CK, Ramasundarahettige C, Hu W, AlHabib KF, Avezum Jr A, Cheng X, et al. Availability and affordability of essential medicines for diabetes across high-income, middle- income, and low-income countries: a prospective epidemiological study. The lancet Diabetes & endocrinology. 2018 Oct 1;6(10):798-808.
23. Attaei MW, Khatib R, McKee M, Lear S, Dagenais G, Igumbor EU, et al. Availability and affordability of blood pressurelowering medicines and the effect on blood pressure control in high-income, middle-income, and low-income countries: an analysis of the PURE study data. The Lancet Public Health. 2017 Sep 1;2(9):e411-9.
24. Gautam VP, Shah A, Malhotra A, Dewanwala A, Taneja DK, Gupta VK, et al. General practitioners’ knowledge of childhood asthma in Delhi, India. The International Journal of Tuberculosis and Lung Disease. 2008 Jun 1;12(6):677-82.
25. Rural Health Statistics, Ministry of Health and Family Welfare Statistics Division, Government of India. [Last cited on 2017 Sep 28]. Available from: http://wcd.nic.in/sites/default/ files/RHS_1.pdf
26. Santhosh YL, Naveen MR. Medication adherence behavior in chronic diseases like asthma and diabetes mellitus. International Journal of Pharmacy and Pharmaceutical Sciences, 2011, Vol 3, Issue 3, 238240.
27. Chaudri NA. Adherence to Long-term Therapies Evidence for Action. Ann Saudi Med. 2004;24(3):221-22. doi:10.5144/0256-4947.2004.221
28. Bovet P et al. Monitoring one-year compliance to antihypertension medication in the Seychelles. Bulletin of the World Health Organization,2002, 80:33-9.
29. Graves JW. Management of difficult-to-control hypertension Mayo Clinic Proceedings,2000, 75:278-284 [erratum published in Mayo Clinical Proceedings,2000, 75:542].
30. van der Sande MA et al. Blood pressure patterns and cardiovascular risk factors in rural and urban Gambian communities. Journal of Human Hypertension,2000, 14:489-96.
31. Guo H, He H, Jiang J. Study on the compliance of antihypertensive drugs in patients with hypertension. Chinese Journal of Epidemiology,2001, 22:418-420.
32. Lee CS, Tan JH, Sankari U, Koh YL, Tan NC. Assessing oral medication adherence among patients with type 2 diabetes mellitus treated with polytherapy in a developed Asian community: a cross-sectional study. BMJ open. 2017 Sep 1;7(9):e016317.
33. Yuvaraj K, Gokul S, Sivaranjini K, Manikandanesan S, Murali S, Surendran G, et al. Prevalence of medication adherence and its associated factors among patients with noncommunicable disease in rural Puducherry, South India–A facility-based cross-sectional study. Journal of family medicine and primary care. 2019 Feb;8(2):701.
34. Misra P, Salve HR, Srivastava R, Kant S, Krishnan A. Adherence to medications among patients with diabetes mellitus (Type 2) at ballabgarh health and demographic surveillance system: A community based study. Indian Journal of Community and Family Medicine. 2018 Jan 1;4(1):24.
35. Jhaj R, Gour PR, Kumari S, Sharma S. Association between medication adherence and blood pressure control in urban hypertensive patients in central India. International Journal of Noncommunicable Diseases. 2018 Jan 1;3(1):9.
36. Balasubramanian A, Nair SS, Rakesh PS, Leelamoni K. Adherence to treatment among hypertensives of rural Kerala, India. Journal of Family Medicine and Primary Care. 2018 Jan;7(1):64.
37. Factors of non-adherence to treatment of chronic illnesses in the slums of Chennai [Internet]. [Cited 2020 September 01]. Available from: https://research.vu.nl/ws/portalfiles/ portal/44886173/chapter+4+Factors+of+non-adherence+to+ treatment+of+chronic+illnesses+in+the+slums+of+Chennai.
38. Prabhune A. Literature review–Understanding the patient’s perception about chronic diseases and conditions, Barrier for non-adherence and poor follow-up. InIKP Centre for Technologies in Public Health (ICTPH), India. IKP Centre for Technologies in Public Health (ICTPH), India 2020.
39. Thakur JS, Paika R, Singh S, Narain JP. COVID-19 and noncommunicable diseases: Impact and the strategic approaches. International Journal of Noncommunicable Diseases. 2020 Apr 1;5(2):29.
40. Singh AK, Gillies CL, Singh R, Singh A, Chudasama Y, Coles B, et al. The Prevalence of Comorbidities and Their Association with Mortality in Patients with COVID-19: A Systematic Review and Meta-Analysis. Available at SSRN 3576854. 2020 Apr 12.
41. COVID-19 and Noncommunicable Diseases (NCDs) [Internet]. [Cited 17 September 2020]. Available from: https://ncdalliance.org/sites/default/files/resource_files/ COVID-19%20and%20NCDs-%20Frequently%20Asked%20 Questions_June2020_2.pdf
42. Piga M, Cangemi I, Mathieu A, Cauli A. Telemedicine for patients with rheumatic diseases: systematic review and proposal for research agenda. In Seminars in Arthritis and Rheumatism 2017 Aug 1 (Vol. 47, No. 1, pp. 121-128). WB Saunders.
43. Alvandi M. Telemedicine and its role in revolutionizing healthcare delivery. The American Journal of Accountable Care. 2017;5(1):e1-5.
44. Palmer K, Monaco A, Kivipelto M, Onder G, Maggi S, Michel JP, et al. The potential long-term impact of the COVID-19 outbreak on patients with non-communicable diseases in Europe: consequences for healthy ageing. Aging Clinical and Experimental Research. 2020 May 26:1.
45. Rajkumar RP. COVID-19 and mental health: A review of the existing literature. Asian journal of psychiatry. 2020 Apr 10:102066.
46. Hossain MM, Sultana A, Purohit N. Mental health outcomes of quarantine and isolation for infection prevention: A systematic umbrella review of the global evidence. Available at SSRN 3561265. 2020 Mar 17.
47. Responding to non-communicable diseases during and beyond the COVID-19 pandemic [Internet]. [Cited 2020 September 24]. Available from: https://apps.who.int/iris/ bitstream/handle/10665/334143/WHO-2019-nCoV-Noncommunicable_ diseases-Evidence-2020.1-eng.pdf
48. Wu, X, Nethery, R.C, Sabath, B.M, Braun, D, Dominici, F. Air pollution and COVID-19 mortality in the United States: strengths and limitations of an ecological regression analysis. Science Advances (in press).
Published
2020-11-25
How to Cite
Dr. Manmohan Singh, Parul Lal. (2020). Non-Communicable Diseases: Challenges and Impact of COVID-19 Pandemic. The Indian Practitioner, 73(11), 30-36. Retrieved from http://articles.theindianpractitioner.com/index.php/tip/article/view/1081
Section
Review article
