The impact of COVID ‐19 on chronic disease management in primary care: lessons for Australia from the international experience

International primary care responses to the coronavirus disease 2019 (COVID-19) pandemic have seen the prioritisation of acute and urgent services for people with COVID-19 as well as seeing many practitioners involved in COVID-19 vaccination counselling and delivery.1, 2 This prioritisation has often resulted in partial or complete disruption to chronic disease management (CDM),1 including care for conditions such as hypertension, diabetes and cancer.2 CDM in Australian primary care has been similarly disrupted, with reports of decreased time spent on CDM activities and preventive care,3 particularly for elements of care that require in-person examination or testing,4 and delays in investigation, diagnosis, referred appointments and elective procedures, resulting in prolonged pain, anxiety and deterioration for patients.5 The introduction of telehealth items under the Medicare Benefits Schedule (MBS) may have both alleviated and contributed to disruption.5-7 Although early data suggested that there was little reduction in the total volume of services provided against the MBS, when accounting for telehealth services, and little change in medications used to manage chronic diseases,8 these data paint a complex and dynamic picture with differential changes in certain service types, such as allied health and referred and non-referred services. A recent study from the United Kingdom has suggested that few studies have reported the impact of increases in COVID-19-related respiratory consultations in primary care and that these consultations might mask other reductions in service volume.9