Impact of the COVID-19 pandemic on the outcomes of Indonesian chronic disease management program
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Sovia Salamah 1 2 , Ristra Ramadhani 3 , Mega Rizkya Arfiana 4 , Ibrahim Syamsuri 5 , David Nugraha 4 , Fauzan Illavi 6 , Asiyah Nida Khafiyya 7 , Astri Dewayani 8 9 , M Rifqi Rokhman 10 11 , Firas Farisi Alkaff 2 8 *
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1 Department of Public Health and Preventive Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, INDONESIA2 Department of Internal Medicine, University Medical Center Groningen, Groningen, THE NETHERLANDS3 Department of Otorhinolaryngology Head & Neck Surgery, Faculty of Medicine, Universitas Airlangga–Dr. Soetomo General Academic Hospital, Surabaya, INDONESIA4 Faculty of Medicine Universitas Airlangga, Surabaya, INDONESIA5 Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Airlangga–Dr. Soetomo General Academic Hospital, Surabaya, INDONESIA6 Department of Internal Medicine, Dr. Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia, Central Jakarta, INDONESIA7 Center for Global Health, University of Chicago, Chicago, IL, USA8 Department of Anatomy, Histology, and Pharmacology, Faculty of Medicine, Universitas Airlangga, Surabaya, INDONESIA9 Department of Infectious Disease Control, Faculty of Medicine, Oita University, Oita, JAPAN10 Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta, INDONESIA11 University Medical Center Groningen, Groningen, THE NETHERLANDS* Corresponding Author

Abstract

Background: The Indonesian Government launched chronic disease management program (PROLANIS) with the aim of improving clinical outcomes and preventing disease complications of patients with type 2 diabetes (T2D). During the coronavirus disease 2019 (COVID-19) pandemic, the overwhelmed healthcare system shifted resources away from non-communicable diseases in the attempt to mitigate it. Thus, the implementation of PROLANIS during the COVID-19 pandemic might not be as optimal as before the pandemic era, leading to worse clinical outcomes. This pilot study aims to evaluate the impact of the COVID-19 pandemic on PROLANIS in rural areas by analyzing the changes of metabolic control and renal function parameters.
Methods: This study used data from three PROLANIS groups report in rural areas in East Java Province, Indonesia. Study population was PROLANIS participants who came for six-month-evaluation in December 2019 (T0), June 2020 (T1), and December 2020 (T2). Evaluated metabolic control parameters were body mass index (BMI), blood pressure, hemoglobin A1C (HbA1C), total cholesterol (TC), high-density lipid, low-density lipid, and triglyceride (TG), whereas evaluated renal function parameters were blood urea nitrogen, serum creatinine, and urinary albumin. Independent t-test and Wilcoxon signed-rank test were used for statistical analyses. p-value <0.05 was considered statistically significant.
Results: Among 52 PROLANIS participants included in the analyses, four metabolic control parameters (BMI, blood pressure, TC, and TG) and all renal function parameters significantly worsened right after the pandemic started but improved 6 months afterwards. Meanwhile, HbA1C continuously worsened throughout the study period, albeit statistically insignificant.
Conclusions: The metabolic control and renal function parameters in our study population deteriorates especially in the beginning of the COVID-19 pandemic.

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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Article Type: Original Article

ELECTRON J GEN MED, Volume 20, Issue 6, December 2023, Article No: em541

https://doi.org/10.29333/ejgm/13661

Publication date: 01 Nov 2023

Online publication date: 11 Sep 2023

Article Views: 1509

Article Downloads: 908

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