{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T11:02:14Z","timestamp":1782903734014,"version":"3.54.5"},"reference-count":31,"publisher":"Royal College of General Practitioners","issue":"730","license":[{"start":{"date-parts":[[2019,2,12]],"date-time":"2019-02-12T00:00:00Z","timestamp":1549929600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Gen Pract"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The COVID-19 pandemic has directly and indirectly had an impact on health service provision owing to surges and sustained pressures on the system. The effects of these pressures on the management of long-term or chronic conditions are not fully understood.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To explore the effects of COVID-19 on the recorded incidence of 17 long-term conditions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and setting<\/jats:title><jats:p>This was an observational retrospective population data linkage study on the population of Wales using primary and secondary care data within the Secure Anonymised Information Linkage (SAIL) Databank.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Monthly rates of new diagnosis between 2000 and 2021 are presented for each long-term condition. Incidence rates post-2020 were compared with expected rates predicted using time series modelling of pre-2020 trends. The proportion of annual incidence is presented by sociodemographic factors: age, sex, social deprivation, ethnicity, frailty, and learning disability.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 5 476 012 diagnoses from 2 257 992 individuals are included. Incidence rates from 2020 to 2021 were lower than mean expected rates across all conditions. The largest relative deficit in incidence was in chronic obstructive pulmonary disease corresponding to 343 (95% confidence interval = 230 to 456) undiagnosed patients per 100 000 population, followed by depression, type 2 diabetes, hypertension, anxiety disorders, and asthma. A GP practice of 10 000 patients might have over 400 undiagnosed long-term conditions. No notable differences between sociodemographic profiles of post- and pre-2020 incidences were observed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>There is a potential backlog of undiagnosed patients with multiple long-term conditions. Resources are required to tackle anticipated workload as part of COVID-19 recovery, particularly in primary care.<\/jats:p><\/jats:sec>","DOI":"10.3399\/bjgp.2022.0353","type":"journal-article","created":{"date-parts":[[2023,1,23]],"date-time":"2023-01-23T17:10:15Z","timestamp":1674493815000},"page":"e332-e339","source":"Crossref","is-referenced-by-count":27,"title":["Impact of COVID-19 pandemic on incidence of long-term conditions in Wales: a population data linkage study using primary and secondary care health records"],"prefix":"10.3399","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0147-1985","authenticated-orcid":false,"given":"Cathy","family":"Qi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0928-3364","authenticated-orcid":false,"given":"Tim","family":"Osborne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2409-2045","authenticated-orcid":false,"given":"Rowena","family":"Bailey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8660-6721","authenticated-orcid":false,"given":"Alison","family":"Cooper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joe P","family":"Hollinghurst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0814-0801","authenticated-orcid":false,"given":"Ashley","family":"Akbari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth","family":"Crowder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holly","family":"Peters","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca-Jane","family":"Law","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth","family":"Lewis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deb","family":"Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6228-4446","authenticated-orcid":false,"given":"Adrian","family":"Edwards","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5225-000X","authenticated-orcid":false,"given":"Ronan A","family":"Lyons","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1987","published-online":{"date-parts":[[2023,1,23]]},"reference":[{"key":"2023050902550603000_73.730.e332.1","unstructured":"Technical Advisory Group, Welsh Government (2021) Five harms arising from COVID-19: consideration of potential baseline measures, https:\/\/gov.wales\/sites\/default\/files\/publications\/2021-07\/technical-advisory-group-5-harms-arising-from-covid-19_0.pdf (accessed 17 Feb 2023)."},{"issue":"8","key":"2023050902550603000_73.730.e332.2","first-page":"900","article-title":"Long-term impact of COVID-19: a systematic review of the literature and meta-analysis","volume":"9","author":"Sanchez-Ramirez","year":"2021","journal-title":"Biomed"},{"key":"2023050902550603000_73.730.e332.3","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n339"},{"key":"2023050902550603000_73.730.e332.4","unstructured":"Department of Health and Social Care (2012) Long term conditions compendium of information: third edition, https:\/\/www.gov.uk\/government\/publications\/long-term-conditions-compendium-of-information-third-edition (accessed 17 Feb 2023)."},{"key":"2023050902550603000_73.730.e332.5","unstructured":"Watt T Firth Z Fisher R Kelly E (Sep 17, 2020) Use of primary care during the COVID-19 pandemic: patient-level data analysis of the impact of COVID-19 on primary care activity in England. 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