Co-first author of this published piece, the full text of which can be found on Chronic Illness.

Objectives

This study aims to examine the impact of COVID-19 measures on wellbeing and self-management in medically vulnerable non-COVID patients and their views of novel modalities of care in Singapore.

Methods

Patients with cardiovascular disease (CVD), respiratory disease, chronic kidney disease, diabetes and cancer were recruited from the SingHealth cluster and national cohort of older adults. Data on demographics, chronic conditions and perceived wellbeing were collected using questionnaire. We performed multivariable regression to examine factors associated with perceived wellbeing. Qualitative interviews were conducted to elicit patient's experience and thematically analyzed.

Results

A total of 91 patients participated. Male patients compared with female patients perceived a lower impact of the pandemic on subjective wellbeing. Patients with CVD compared to those having conditions other than CVD perceived a lower impact. Impacts of the pandemic were primarily described in relation to emotional distress and interference in maintaining self-care. Hampering of physical activity featured prominently, but most did not seek alternative ways to maintain activity. Despite general willingness to try novel care modalities, lack of physical interaction and communication difficulties were perceived as main barriers.

Discussion

Our findings suggest that COVID-19 generally had a moderately low impact on the overall health and wellbeing of medically vulnerable patients. This is in contrast with prior literature that reported non-COVID patients with chronic conditions having been prioritized lower in other countries, with neglected chronic disease management forming a possible “invisible epidemic”. The findings also underline the need to alleviate emotional distress and develop adaptive strategies to empower patients to maintain wellbeing and self-care.