Welcome to the 26th WONCA Europe Virtual Conference Programme Scheduling

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Background and purpose: Healthcare workers are exposed to a high risk of contagion by the SARS-CoV-2. The aim of this cross-sectional study was to identify the sociodemographic, clinical and epidemiological characteristics associated with the SARS-CoV-2 infection in family physicians (GPs) who carry out their work in Primary Care or in Emergency Departments.

Methods: GPs who underwent an RT-PCR test (real-time polymerase chain reaction) for the detection of the SARSCoV-2 were included. Sociodemographic and work variables were collected, as well as contact with COVID-19 patients, symptoms presented during the process, previous chronic morbidities and smoking, through an ad-hoc online questionnaire (Google form). Odds Ratios (OR) were estimated to measure the magnitude of the association between those variables and the presence of SARS-CoV-2 infection (logistic regression).

Results: 133 out of 969 FPs were PCR positive (13.7%; 95% CI: 11.6-16.0%). The most frequently declared symptoms were fatigue/tiredness (69.2%; 95% CI: 60.9-77.4%), cough (56.4%, 95% CI: 47.6-65.2 %) and headache (55.6%, 95% CI: 46.8-64.4%). The variables independently associated with SARS-CoV-2 infection were previous contact with a COVID-19 patient (OR: 2.3; 95% CI: 1.2-4.2 ), fatigue/tiredness (OR: 2.2; 95% CI: 1.2-3.9), olfactory dysfunction (4.6, 95% CI: 1.7-12.5), gustatory dysfunction (OR: 32.0; 95% CI: 9.6-106.8), cough (OR: 3.0; 95% CI: 1.7-5.3) and fever (OR: 6.1; 95% CI: 3, 2-11.4).

Conclusions: Early detection of selected symptoms could help to suspect COVID-19 disease in GPs, mainly if a previous contact with a COVID-19 patient has been documented.

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Background and Purpose: In March 2020, MHealth Fairview System (12 hospitals and 60 clinics) deployed a remote patient monitoring (RPM) technology to increase access to care for patients with COVID-19 and reduce strain on in-person services. University of Minnesota Medical School faculty, residents and students served as the team monitoring patients and delivering care. We studied the effect of this RPM solution on health care utilization by patients with presumptive COVID-19.

Methods: We conducted a retrospective study comparing health care utilization by patients enrolled in the RPM program (n=4435) and those who declined enrollment (n=2742). Primary outcomes were ER visits, hospital and ICU admissions, and death. We used logistic regression to adjust for known risk factors of COVID-19 severity.

Results: Adjusted for COVID-19 risk factors, there was a significant decrease in the risk of death for the group enrolled in the RPM: aOR:0.50 (95%CI:0.30,0.83). There were no significant associations between enrollment and the other primary outcomes. Increasing number of interactions with the RPM was associated with fewer hospital admissions: aOR:0.92 (95%CI:0.88,0.95).

Conclusions: The COVID-19 pandemic strained health care systems and led to dramatic shifts in health care systems delivery in an attempt to alleviate this strain. The RPM was associated with reductions in hospitalization, ICU admissions and most notably in death. More research is needed to determine if these technologies provide added benefit to traditional health care systems.

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Background and purpose: General practitioners (GPs) play a significant role in providing medical care to patients with COVID-19. They have to deal with the risks and consequences of the pandemic in both their professional and personal life. In this qualitative study we investigated GPs’ experiences of the COVID-19-pandemic using semi-structured interviews.

Methods: This qualitative study is part of a cross-sectional study with a mixed methods design, involving GPs in four federal states of Germany. Overall, 22 GPs participated in semi-structured interviews by telephone. We analyzed data according to Udo Kuckartz’ method of content analysis and used MAXQDA (version 2020).

Results: First results show that GPs rapidly reorganized their practice management and implemented new treatment strategies. GPs reported that continuity of care was ensured, however, they expressed their worries about how their social distancing practice may affect the relationship with their patients. GPs perceived a responsibility for their patients’ health, and therefore, they did not want to risk becoming infected and passing on the virus onto others. Facing several new challenges at work, the majority of respondents experienced psychological distress. Different solutions for improving primary care during the pandemic were suggested, such as facilitating cooperation and access to sources for advice and that administrative departments should provide clear information and consistent guidance.

Conclusions: This study provides insight into GPs’ experiences and perceptions of the current pandemic situation and can indicate potential ways on how to strengthen primary care in future disease outbreaks.

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1) In 2020, the COVID-19 pandemic impacted the frequency of (antibiotically treated) respiratory tract infections (RTIs) in primary care. We aimed to assess the frequency of general practitioner consultations and antibiotic prescribing for common infections, particularly RTIs, per week during the first wave.

2) Routine health care data from the Julius General Practitioners’ Network were collected from March - May 2019 (n=389,708) and March - May 2020 (n=405,688 registered patients). Data on consultations for respiratory/ear, urinary, gastrointestinal and skin infections were collected. The numbers of infectious disease episodes (total and those treated with antibiotics), were calculated and compared.

3) Fewer RTI episodes were observed during the pandemic (RR 0.90 [CI 0.88-0.92]) and fewer RTI episodes were treated with antibiotics (RR 0.54 [CI 0.52-0.58]). The antibiotic prescription rate declined (21% to 13%). The decline in RTI episodes and antibiotic prescribing took place during weeks 15-19, mid-COVID-19 wave, after an initial peak in week 11, the first week of lock-down. Decreases in number of RTI episodes were most notable in the youngest and oldest age categories (RR 0.61 [CI 0.58-0.64] and RR 0.82 [CI 0.78-0.86], respectively). The antibiotic prescription rate decreased in all age categories. We found no evidence of an increase in complications (pneumonia, mastoiditis).

4) Our findings indicate that the frequency of RTI episodes and antibiotic prescribing decreased in the weeks 15-19, mid-way through the first wave of the COVID-19 pandemic, after an initial peak the first week of lock-down. Decreases in the number of RTI episodes were most notable in the youngest and oldest patients.

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Background and purpose: The COVID-19 pandemic led to the adoption of measures to detect infection and prevent its spread, causing anxiety in the population as a collateral damage. Health professionals have been considered one of the groups most at risk for mental health problems, as observed in previous epidemics. The present study aimed to assess the anxiety in primary healthcare professionals during the COVID-19 pandemic and identify the factors that influence it.

Methods: This is a cross-sectional study performed through Google Forms platform between March 29 and April 5 2020 to primary healthcare professionals in mainland Portugal. Anxiety levels were obtained applying the Beck Anxiety Inventory, which was related to other variables.

Results: the study included 696 participants, of which 61.9% were physicians, 84.8% were women and 43.8% had mild to severe levels of anxiety. Factors such as personal history of previous mental health disorders, having a family member with risk factors for COVID-19 complications and being an administrative assistant, showed to be related with higher levels of anxiety. Moreover, the existence of a workspace contingency plan was associated with lower anxiety levels; nevertheless, 6.9% considered it inadequate, mainly due to inadequate protective equipment for professionals (79.6%).

Conclusion: The study highlights a baseline high prevalence of anxiety among health professionals even at the early beginning of COVID-19 pandemic and reinforces the need, in future pandemics, to take adequate measures to protect their mental health safeguarding the quality of patient care.

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BACKGROUND

In 2020, a considerable change affected our family practices, priorities and the interactions with our patients. As a big part of patient-doctor contacts has gone online, and valuable was reduced to correspondence via e-mail, phone calls, video conferences. Clinical specialists expressed a concern due to the noticeable reduction of the number of referrals of patients to the secondary level, in the United Kingdom the reduction was up to 80%. Inevitably the question arises: have we neglected patients with other diseases due to combating COVID-19? Some scientific evidence concerning this topic will be presented.

AIMS AND LEARNING OBJECTIVES

To understand the continuous demand of healthcare during COVID-19

Facilitate exchange of best practices concerning organisational approach of FP/GP during COVID-19 epidemics.

Attempt to develop one health concept-preparing for long COVID

METHODS AND TIMETABLE

The following methods will be implemented: a short plenary presentation (25 minutes); a discussion in small groups about the experiences in different environments (25 minutes); formulating and listing proposals for organisational changes/adaptations of the FP/GP practices; by returning to plenary, a moderated discussion with the goal od formulating an outline/framework compliant with long COVID

CONCLUSIONS

Take-home messages, including practical tools for dealing with long COVID in primary care, will be presented in conclusion of the workshop.