RT Journal Article
SR Electronic
T1 Physician visits and medication prescriptions for major chronic diseases during the COVID-19 pandemic in Japan: retrospective cohort study
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e050938
DO 10.1136/bmjopen-2021-050938
VO 11
IS 7
A1 Itsuki Osawa
A1 Tadahiro Goto
A1 Yuko Asami
A1 Noriharu Itoh
A1 Yasuyuki Kaga
A1 Yuji Yamamoto
A1 Yusuke Tsugawa
YR 2021
UL http://bmjopen.bmj.com/content/11/7/e050938.abstract
AB Objectives There have been concerns that patients with chronic conditions may be avoiding in-person physician visits due to fear of COVID-19, leading to lower quality of care. We aimed to investigate changes in physician visits and medication prescriptions for chronic diseases before and during the COVID-19 pandemic at the population level.Design Retrospective cohort study.Setting Nationwide claims data in Japan, 2018–2020.Participants Working-age population (aged 18–74 years) who visited physicians and received any prescriptions for major chronic diseases (hypertension, diabetes and dyslipidaemia) before the pandemic.Outcome measures The outcomes were the monthly number of physician visits, the monthly proportion of physician visits and the monthly proportion of days covered by prescribed medication (PDC) during the pandemic (April–May 2020, as the first state of emergency over COVID-19 was declared on 7 April, and withdrawn nationally on 25 May).Results Among 10 346 patients who visited physicians for chronic diseases before the pandemic, we found a temporary decline in physician visits (mean number of visits was 1.9 in March vs 1.7 in April; p<0.001) and an increase in the proportion of patients who did not visit any physicians during the pandemic (15% in March vs 24% in April; p<0.001). Physician visits returned to the baseline in May (the mean number of visits: 1.8, and the proportion of patients who did not visit any physicians: 9%). We observed no clinically meaningful difference in PDC between before and during the pandemic (eg, 87% in March vs 87% in April; p=0.45). A temporary decline in physician visits was more salient in seven prefectures with a larger number of COVID-19 cases than in other areas.Conclusions Although the number of physician visits declined right after the COVID-19 outbreak, it returned to the baseline one month later; patients were not skipping medications during the pandemic.The MinaCare data are proprietary to MinaCare, Co., Ltd. and not publicly available for research purposes. Researchers who would like to access the data for research purposes should contact Dr. Yuji Yamamoto (mc_info@minacare.co.jp) to make a data use agreement and pay a data-availability fee.