Outcomes of the Indonesian Chronic Disease Management Program (PROLANIS) in Patients with Hypertension During the COVID-19 Pandemic in Rural Areas:A Preliminary Evaluation Study

Background: The Indonesian Chronic Disease Management Program (PROLANIS) is a government program that aims to improve the health outcomes of patients with chronic diseases, including hypertension. This preliminary study aimed to evaluate the impacts of the coronavirus disease 2019 (COVID-19) pandemic on the health outcomes of hypertension patients in rural areas who were enrolled in PROLANIS. Material/Methods: This study used data from 4 PROLANIS groups in East Java province. The data were collected from participants' 6-month evaluations at 3 time points: before the COVID-19 pandemic in December 2019 (T0), during the COVID-19 pandemic in June 2020 (T1), and in December 2020 (T2). Evaluated parameters were body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), low-density lipid (LDL), high-density lipid (HDL), triglyceride (TG), and estimated glomerular filtration rate (eGFR). Results: There were 91 patients included in the analyses. Compared to T0, BMI, blood pressure, eGFR, and TC had significantly deteriorated at T1, but LDL, HDL, and TG showed no marked changes. At T2, BMI, DBP, and TC were similar to T0. On the other hand, SBP and eGFR did not improve, while HDL significantly deteriorated. Stratified based on age, worsening of DBP, TC, and LDL at T1 and eGFR at T1 and T2 was only observed in those aged 60 years and older. Conclusions: This preliminary study showed that the health outcomes of hypertension patients in rural areas who were enrolled in PROLANIS were negatively impacted during the COVID-19 pandemic, with the elderly being the most affected.</p

Impact of the COVID-19 pandemic on the outcomes of Indonesian chronic disease management program

Background: The Indonesian Government launched chronic disease management program (PROLANIS) with the aim of improving clinical outcomes and preventing disease complications of patients with type 2 diabetes (T2D). During the coronavirus disease 2019 (COVID-19) pandemic, the overwhelmed healthcare system shifted resources away from non-communicable diseases in the attempt to mitigate it. Thus, the implementation of PROLANIS during the COVID-19 pandemic might not be as optimal as before the pandemic era, leading to worse clinical outcomes. This pilot study aims to evaluate the impact of the COVID-19 pandemic on PROLANIS in rural areas by analyzing the changes of metabolic control and renal function parameters.Methods: This study used data from three PROLANIS groups report in rural areas in East Java Province, Indonesia. Study population was PROLANIS participants who came for six-month-evaluation in December 2019 (T0), June 2020 (T1), and December 2020 (T2). Evaluated metabolic control parameters were body mass index (BMI), blood pressure, hemoglobin A1C (HbA1C), total cholesterol (TC), high-density lipid, low-density lipid, and triglyceride (TG), whereas evaluated renal function parameters were blood urea nitrogen, serum creatinine, and urinary albumin. Independent t-test and Wilcoxon signed-rank test were used for statistical analyses. p-value &lt;0.05 was considered statistically significant.Results: Among 52 PROLANIS participants included in the analyses, four metabolic control parameters (BMI, blood pressure, TC, and TG) and all renal function parameters significantly worsened right after the pandemic started but improved 6 months afterwards. Meanwhile, HbA1C continuously worsened throughout the study period, albeit statistically insignificant.Conclusions: The metabolic control and renal function parameters in our study population deteriorates especially in the beginning of the COVID-19 pandemic