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 Table of Contents  
ORIGINAL ARTICLE
Year : 2021  |  Volume : 6  |  Issue : 1  |  Page : 24-26

Impact of COVID-19 pandemic on health services provided to elderly population in Saudi Arabia


1 Family Medicine and Women's Health Consultant, Assistant Professor of Family Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia
2 Medical Student, College of Medicine, King Khalid University, Abha, Aseer, Saudi Arabia

Date of Submission15-Feb-2021
Date of Acceptance25-Apr-2021
Date of Web Publication31-Jul-2021

Correspondence Address:
Hayfa AlHefdhi
Family Medicine and Women's Health Consultant, Assistant Professor of Family Medicine, College of Medicine, King Khalid University, Abha, Aseer
Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/KKUJHS.KKUJHS_5_21

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  Abstract 


Background: Pandemics are not becoming infrequent events anymore. It is estimated that over 12,000 outbreaks have occurred since the year 1980, thanks to ease of travel and change in land use (Smith et al., 2014; Joes et al., 2008). The current coronavirus disease of 2019 (COVID-19) pandemic have exposed the lack of preparedness in well-connected, economically stable, developed countries. All aspects of life have changed dramatically. COVID-19 infection affects older adults with higher morbidity and mortality and those with chronic underlying medical disorders [Zhang et al., 2020]. There is an indirect effect of COVID-19 pandemic on elderly, related to quarantine and social isolation. Prolonged social isolation leads to several neurological, psychological, and medical morbidities in the elderly [Plagg et al., 2020]. On the other hand, hospital-based and community-based medical care for acute and chronic diseases was disrupted substantially during the pandemic, adding to the suffering endured by older adults. Such impact received little focus in contemporary research, especially in Saudi Arabia. Objectives: The main aim of our current investigation is to evaluate the impact of quarantine and medical care disruption on geriatric health during the COVID-19 pandemic in Saudi Arabia. Materials and Methods: We surveyed the elderly population in Saudi Arabia using a pre-designed electronic online questionnaire in Arabic language. The items were developed by collaborating with practicing family physicians, geriatricians affiliated to King Khalid University, and with service users. The link to the questionnaire was released unto social media and the elderly -and their carers- were encouraged to participate in the study. We collected sociodemographic as well as clinical data. A pilot study was conducted for a period of two months before the final version of the research tool was released. We utilized χ2 tests to evaluate the effect of categorical demographic and clinical variables. Statistical tests were 2-tailed. Significance level was set at probability (type 1 error) = 0.05. The statistical software used was SPSS, Version V27 for Windows. The study received approval from the Ethics committee in King Khalid University. Results: A total of (n = 297) Saudi elderly persons were included in the survey, of whom (n = 35, 11.8%) were men and (n = 262, 88.2%) were women. (n = 190, 64.0%) were between 65 and 74 years of age and (n = 107, 36.0%) were 75 or older. The most frequently encountered health problem was Diabetes Mellitus in (n = 126, 42.4%) followed by hypertension in (n = 117, 39.4%). (n = 117, 39.4%) reported having their urgent care needs delayed because of fear of COVID-19 infection. (n = 164, 55.2%) reported that the pandemic posed a negative effect on their mood, and further (n = 108, 36.4%) had their physical activities negatively affected. Treatment plan was impaired in (40, 13.5%) of the participants. In independent subjects (n = 24, 32.9%) were not enjoying daily activities post-pandemic, compared to (n = 63, 34.1%) who were partially dependent and (n = 7, 17.9%) who were totally dependent on others (P = 0.037). Conclusion: We surveyed a sample of elderly people in Saudi Arabia to explore their experience of interruption in healthcare services. We found 21% did not receive their medications and 39.4% had their urgent needs delayed. Physical activities, mood and enjoyment sense were all impaired. We should take into account the disruption in health services provision caused by the current COVID-19 pandemic when planning for post-pandemic geriatric healthcare.

Keywords: Coronavirus disease of 2019, elderly, health services


How to cite this article:
AlHefdhi H, Alkahtani F, Shamakhi F, Alrazhi F, Alqahtani A, Alsharaif A, Habtar S. Impact of COVID-19 pandemic on health services provided to elderly population in Saudi Arabia. King Khalid Univ J Health Sci 2021;6:24-6

How to cite this URL:
AlHefdhi H, Alkahtani F, Shamakhi F, Alrazhi F, Alqahtani A, Alsharaif A, Habtar S. Impact of COVID-19 pandemic on health services provided to elderly population in Saudi Arabia. King Khalid Univ J Health Sci [serial online] 2021 [cited 2021 Nov 28];6:24-6. Available from: https://www.kkujhs.org/text.asp?2021/6/1/24/322884




  Introduction Top


Pandemics are not becoming infrequent events anymore. It is estimated that over 12,000 outbreaks have occurred since the year 1980, thanks to ease of travel and change in land use.[1],[2] The current coronavirus disease of 2019 (COVID-19) pandemic has exposed the lack of preparedness in well-connected, economically stable, developed countries. All aspects of life have changed dramatically. COVID-19 infection affects older adults with higher morbidity and mortality and those with chronic underlying medical disorders.[3] There is an indirect effect of COVID-19 pandemic on the elderly, related to quarantine and social isolation. Prolonged social isolation leads to several neurological, psychological, and medical morbidities in the elderly.[4] On the other hand, hospital-based and community-based medical care for acute and chronic diseases was disrupted substantially during the pandemic, adding to the suffering endured by older adults. Such impact received little focus on contemporary research, especially in Saudi Arabia.

The main aim of our current investigation is to evaluate the impact of quarantine and medical care disruption on geriatric health during the COVID-19 pandemic in Saudi Arabia.


  Methods Top


We surveyed the elderly population in Saudi Arabia using a predesigned electronic online questionnaire in the Arabic language. The items were developed by collaborating with practicing family physicians, geriatricians affiliated to King Khalid University, and with service users. The link to the questionnaire was released unto social media and the elderly – and their carers – were encouraged to participate in the study. We collected sociodemographic as well as clinical data. A pilot study was conducted for a period of 2 months before the final version of the research tool was released. We utilized Chi-squared tests to evaluate the effect of categorical demographic and clinical variables. Statistical tests were two tailed. Significance level was set at probability (type 1 error) = 0.05. The statistical software used was SPSS, Version V27 (King Khalid University, Abha, Aseer Region, Saudi Arabia) for Windows. The study received approval from the Ethics Committee of King Khalid University [Supplementary Table 1].




  Results Top


A total of 297 Saudi elderly persons were included in the survey, of whom 35 (11.8%) were men and 262 (88.2%) were women. One hundred and ninety (64.0%) elderly persons were between 65 and 74 years of age and 107 (36.0%) were 75 or older. The most frequently encountered health problem was diabetes mellitus in 126 (42.4%), followed by hypertension in 117 (39.4%) elderly persons [Supplementary Table 1].

One hundred and seventeen (39.4%) reported having their urgent care needs delayed because of fear of COVID-19 infection. One hundred and sixty four (55.2%) reported that the pandemic posed a negative effect on their mood, and further 108 (36.4%) had their physical activities negatively affected. Treatment plan was impaired in 40 (13.5%) participants [Table 1]. In independent subjects, 24 (32.9%) were not enjoying daily activities post pandemic, compared to 63 (34.1%) who were partially dependent and 7 (17.9%) who were totally dependent on others (P = 0.037).
Table 1: Distribution of elderly care during coronavirus disease.19 pandemic according to the site of care delivery

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  Discussion Top


We found that 21% of the elderly did not receive their medications during the pandemic. We also found that 39.4% described the delay in their urgent care needs during the pandemic [Supplementary Table 2]. Interruption in medical care was a notable finding internationally as elderly patients did not return to fill their prescriptions out of fear of COVID-19 infection.[5] These interruptions in medications were linked to relapses in chronic medical and mental illness among the elderly during the pandemic.[6] There was a delicate balance to be struck between infection risk and medications' interruption risk. One solution was to set up outdoor dispensary units that were effective in curbing medications' interruption.[5]



Over a third of the surveyed elderly reported a negative impact for the pandemic on their physical activities, and, when directly asked if their mood was affected by the pandemic, over a half reported a detrimental effect on their mood [Supplementary Table 3] and [Supplementary Table 4]. Cocooning of the elderly meant a substantial reduction in the duration and vigorousness of their allowed physical activity. There was a genuine concern that leads to sedentary lifestyle in over a third of the Japanese elderly, which constituted a secondary public health crisis during the current pandemic.[7] Furthermore, according to our results, enjoyment of daily activities was impaired in 31.6% of the Saudi elderly. Clearly, these findings tally with the negative psychological consequences the pandemic had on the elderly worldwide.[8] We should encourage physical activities among the elderly by providing safe environment both in private and governmental settings as well as personal homes.



Disruption and delay of outpatient clinical services were inevitable during the COVID-19 crisis.[9] According to our results, in governmental and private health-care facilities, there was a longer delay during the pandemic in providing scheduled and urgent medical care than in home care facilities. Our current investigation provides evidence that Saudi home care services were more efficient than hospital-based care during the crisis. This could be due to the clearer workload and unified pathways adopted by home care services in Saudi Arabia. Future research should examine how these services could be developed and improved [Supplementary Table 2].

Limitations of this study include cross-sectional online descriptive design and selection biases it creates. Nonetheless, to the best of our knowledge, the current investigation was the first of its kind to explore the impact of the COVID-19 pandemic on elderly Saudi patients.


  Conclusion Top


We surveyed a sample of elderly people in Saudi Arabia to explore their experience of interruption in healthcare services. We found 21% did not receive their medications and 39.4% had their urgent needs delayed. Physical activities, mood and enjoyment sense were all impaired. We should take into account the disruption in health services provision caused by the current COVID-19 pandemic when planning for post-pandemic geriatric healthcare.



 
  References Top

1.
Jones KE, Patel NG, Levy MA, Storeygard A, Balk D, Gittleman JL, et al. Global trends in emerging infectious diseases. Nature 2008;451:990-3.  Back to cited text no. 1
    
2.
Smith KF, Goldberg M, Rosenthal S, Carlson L, Chen J, Chen C, et al. Global rise in human infectious disease outbreaks. J R Soc Interface 2014;11:20140950.  Back to cited text no. 2
    
3.
Zhang L, Fan T, Yang S, Feng H, Hao B, Lu Z, et al. Comparison of clinical characteristics of COVID-19 between elderly patients and young patients: A study based on a 28-day follow-up. Aging (Albany NY) 2020;12:19898-910.  Back to cited text no. 3
    
4.
Plagg B, Engl A, Piccoliori G, Eisendle K. Prolonged social isolation of the elderly during COVID-19: Between benefit and damage. Arch Gerontol Geriatr 2020;89:104086.  Back to cited text no. 4
    
5.
Hsiao SH, Chang HM, Kang YT, Chen YH. Mitigate risks of medication interruption due to COVID-19 for elderly with chronic diseases. Kaohsiung J Med Sci 2020;36:661-2.  Back to cited text no. 5
    
6.
Mehra A, Rani S, Sahoo S, Parveen S, Singh AP, Chakrabarti S, et al. A crisis for elderly with mental disorders: Relapse of symptoms due to heightened anxiety due to COVID-19. Asian J Psychiatr 2020;51:102114.  Back to cited text no. 6
    
7.
Yamada K, Yamaguchi S, Sato K, Fuji T, Ohe T. The COVID-19 outbreak limits physical activities and increases sedentary behavior: A possible secondary public health crisis for the elderly. J Orthop Sci 2020;25:1093-4.  Back to cited text no. 7
    
8.
Javadi SM, Nateghi N. COVID-19 and its psychological effects on the elderly population. Disaster Med Public Health Prep 2020;14:e40-1.  Back to cited text no. 8
    
9.
Di Tano G, Verde S, Loffi M, De Maria R, Danzi GB. Le ricadute della pandemia COVID-19 sulla gestione dell'Ambulatorio Scompenso. Esperienze e considerazioni operative dopo il lockdown [Impact of the COVID-19 pandemic on the management of heart failure outpatient clinics. Lessons during the lockdown restrictions]. G Ital Cardiol (Rome) 2020;21:750-6.  Back to cited text no. 9
    



 
 
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