Incidence of primary care chest pain consultations during the COVID-19 pandemic: an interrupted time series analysis with routine care data
Abstract Background The COVID-19 lockdown had profound effects on society and healthcare. Cardiology departments reported declines in chest pain evaluations and acute coronary syndrome (ACS) diagnoses. However, the pattern of chest pain in primary care is not clear yet. This study aims to assess the...
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BMC
2024-12-01
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| Series: | BMC Primary Care |
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| Online Access: | https://doi.org/10.1186/s12875-024-02676-y |
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| author | Simone van den Bulk Jasper W. A. van Egeraat Annelieke H. J. Petrus Mattijs E. Numans Tobias N. Bonten |
| author_facet | Simone van den Bulk Jasper W. A. van Egeraat Annelieke H. J. Petrus Mattijs E. Numans Tobias N. Bonten |
| author_sort | Simone van den Bulk |
| collection | DOAJ |
| description | Abstract Background The COVID-19 lockdown had profound effects on society and healthcare. Cardiology departments reported declines in chest pain evaluations and acute coronary syndrome (ACS) diagnoses. However, the pattern of chest pain in primary care is not clear yet. This study aims to assess the impact of the COVID-19 lockdown on the number of patients presenting with chest pain in primary care. Methods Routine primary care data from the Extramural LUMC (Leiden University Medical Center) Academic Network (ELAN) in the Netherlands were used. Chest pain consultations from January 2017 to December 2020 were included. An interrupted time series analysis was performed to compare the incidence rate (IR) of chest pain consultations during the COVID-19 lockdown to the expected IR. Secondary outcomes were the type of consultations, referral proportions, and the IR of registered ACS diagnoses. Results In total 9,908 chest pain consultations were included. During the COVID-19 lockdown the IR was 6.16 per 1000 person-years while the expected IR was 7.55 (95% CI 7.03–8.12). The immediate effect of the lockdown yielded an incidence rate ratio (IRR) of 0.62 (95% CI 0.50–0.77). A similar decrease was seen for ACS diagnoses (IRR 0.62, 95% CI 0.48–0.79), with no compensatory increase after the lockdown (IRR 1.04, 95% CI 0.89–1.21). Face-to-face consultations shifted to telephone consultations (p < 0.001) and hospital referrals decreased (9.9% vs. 19.0% (p < 0.001)). Conclusions During the COVID-19 lockdown the number of chest pain consultations and registered ACS diagnoses in primary care decreased significantly. In addition, fewer patients were assessed face-to-face and fewer patients were referred to the hospital. |
| format | Article |
| id | doaj-art-52e858e098ef4c9cbf71c6cc8c0a6d1d |
| institution | OA Journals |
| issn | 2731-4553 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Primary Care |
| spelling | doaj-art-52e858e098ef4c9cbf71c6cc8c0a6d1d2025-08-20T02:31:47ZengBMCBMC Primary Care2731-45532024-12-012511710.1186/s12875-024-02676-yIncidence of primary care chest pain consultations during the COVID-19 pandemic: an interrupted time series analysis with routine care dataSimone van den Bulk0Jasper W. A. van Egeraat1Annelieke H. J. Petrus2Mattijs E. Numans3Tobias N. Bonten4Department of Public Health and Primary Care, Leiden University Medical CenterDepartment of Public Health and Primary Care, Leiden University Medical CenterDepartment of Public Health and Primary Care, Leiden University Medical CenterDepartment of Public Health and Primary Care, Leiden University Medical CenterDepartment of Public Health and Primary Care, Leiden University Medical CenterAbstract Background The COVID-19 lockdown had profound effects on society and healthcare. Cardiology departments reported declines in chest pain evaluations and acute coronary syndrome (ACS) diagnoses. However, the pattern of chest pain in primary care is not clear yet. This study aims to assess the impact of the COVID-19 lockdown on the number of patients presenting with chest pain in primary care. Methods Routine primary care data from the Extramural LUMC (Leiden University Medical Center) Academic Network (ELAN) in the Netherlands were used. Chest pain consultations from January 2017 to December 2020 were included. An interrupted time series analysis was performed to compare the incidence rate (IR) of chest pain consultations during the COVID-19 lockdown to the expected IR. Secondary outcomes were the type of consultations, referral proportions, and the IR of registered ACS diagnoses. Results In total 9,908 chest pain consultations were included. During the COVID-19 lockdown the IR was 6.16 per 1000 person-years while the expected IR was 7.55 (95% CI 7.03–8.12). The immediate effect of the lockdown yielded an incidence rate ratio (IRR) of 0.62 (95% CI 0.50–0.77). A similar decrease was seen for ACS diagnoses (IRR 0.62, 95% CI 0.48–0.79), with no compensatory increase after the lockdown (IRR 1.04, 95% CI 0.89–1.21). Face-to-face consultations shifted to telephone consultations (p < 0.001) and hospital referrals decreased (9.9% vs. 19.0% (p < 0.001)). Conclusions During the COVID-19 lockdown the number of chest pain consultations and registered ACS diagnoses in primary care decreased significantly. In addition, fewer patients were assessed face-to-face and fewer patients were referred to the hospital.https://doi.org/10.1186/s12875-024-02676-yChest painCOVID-19Primary health careRoutinely collected health dataInterrupted time series analysis |
| spellingShingle | Simone van den Bulk Jasper W. A. van Egeraat Annelieke H. J. Petrus Mattijs E. Numans Tobias N. Bonten Incidence of primary care chest pain consultations during the COVID-19 pandemic: an interrupted time series analysis with routine care data BMC Primary Care Chest pain COVID-19 Primary health care Routinely collected health data Interrupted time series analysis |
| title | Incidence of primary care chest pain consultations during the COVID-19 pandemic: an interrupted time series analysis with routine care data |
| title_full | Incidence of primary care chest pain consultations during the COVID-19 pandemic: an interrupted time series analysis with routine care data |
| title_fullStr | Incidence of primary care chest pain consultations during the COVID-19 pandemic: an interrupted time series analysis with routine care data |
| title_full_unstemmed | Incidence of primary care chest pain consultations during the COVID-19 pandemic: an interrupted time series analysis with routine care data |
| title_short | Incidence of primary care chest pain consultations during the COVID-19 pandemic: an interrupted time series analysis with routine care data |
| title_sort | incidence of primary care chest pain consultations during the covid 19 pandemic an interrupted time series analysis with routine care data |
| topic | Chest pain COVID-19 Primary health care Routinely collected health data Interrupted time series analysis |
| url | https://doi.org/10.1186/s12875-024-02676-y |
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