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HELSEVEL-Gode og effektive helse-, omsorgs- og velferdstjenester

CovidNor - Experiences of patients and primary health care professionals during the COVID-19 epidemic in Norway

Alternativ tittel: CovidNor - Erfaringer blant pasienter og helsearbeidere i norsk primærhelsetjeneste under Covid-19 epidemien

Tildelt: kr 5,0 mill.

De fleste pasienter med COVID19 har et mildere sykdomsforløp og behandles utenfor sykehus. I prosjektet CovidNor har vi undersøke symptomer, plager og bekymringer hos pasienter som behandles i primærhelsetjenesten, og vi har utforsket hvordan fastleger og kommuneleger håndterer pandemien. Prosjektet har bestått av tre arbeidspakker: 1. En nettbasert spørreundersøkelse, hvor vi har samlet inn opplysninger om symptomer, oppfølging og bekymringer hos personer i isolasjon eller karantene. Studien pågikk fra mars/april 2020 frem til juli 2021. Resultater er ventet snarlig i vitenskapelige tidsskrift, og noe presenteres i relevante fora. Vi vil senere knytte disse opplysningene til data fra ulike helseregistre for å identifisere mulige faktorer som er forbundet med utvikling av et mer alvorlig sykdomsforløp samt mulige komplikasjoner og langtidseffekter av COVID19. 2. Gjennom forskningsnettverket PraksisNett gjorde fastleger registrering av informasjon om hvordan pasienter med luftveisinfeksjon var i kontakt med legen, undersøkt, behandlet og fulgt opp i løpet av pandemien. Foreløpige resultater herfra er presentert muntlig i forskningsfora. En vitenskapelig artikkel er for tiden under utarbeidelse. 3. Vi har dybdeintervjuet fastleger, legevaktsoverleger og kommuneoverleger i Norge og smittevernpersonell i Sverige om håndtering av pandemien. Vi har fokusert på samarbeidet mellom fastleger og kommune, ledelse, kommunikasjon og oppgavefordeling, og tilpasning til en situasjon kjennetegnet av raske endringer. En vitenskapelig artikkel er ventet publisert i 2022, og resterende materiale blir analysert for fremtidig publikasjoner.

The survey data from Covid-19 patients and people in quarantine outside hospitals, will give better knowledge of the presentation and natural history of mild to moderate COVID-19 cases as well as provide insight to the concerns and feeling of safety during the pandemic in Norway. Linking patient trajectories with national health registries might reveal possible risk factors for developing a more severe disease as well as it may disclose possible later complications to the disease. Experiences from health care professionals in primary care on how they adapted to the situation, might aid responses to possible future outbreaks, as well as provide insights when evaluating collaboration between health authorities and municipalities during the pandemic. The results of this project will aid future patients with Covid-19 to better understand their symptoms and risks, as well as aiding primary care health workers diagnosing and treating these patients. The understanding of the response by health officers in municipalities will help preparing and organizing responses to future epidemics.

Current research on the clinical manifestations of COVID-19 have been mainly based on hospitalized patients. However, most infections are not severe and a majority of COVID-19 patients are diagnosed and handled in primary care. The overall project objective is to understand the clinical picture of early, mild to moderate forms of the disease and fears and experience of safeguarding among people personally affected by COVID-19 outside hospitals, as well as the response of the local medical teams in primary health care and the supporting health care system response including infection prevention and control. Through a web-based survey, we will invite people in isolation/quarantine at home to report symptoms and personal experiences and emotions throughout the course of the illness and/or period in isolation/quarantine. The survey results will be linked to registry follow-up to detect complications and long-term effects of COVID-19. We will invite general practitioners (GPs) to record case information of patients with respiratory tract infections during six weeks of the epidemic to provide clinical information of patients presenting to primary care. In-depth interview studies from a primary care perspective of GPs, leaders of municipal out-of-hours units and municipality chief medical officers will provide insight into how health care workers in Norwegian and Swedish primary care handle the epidemic. We want to focus in particular on their experiences of the local health care system responses including infection control. The clinical observational data of cases outside hospitals, both self-reported data and reported by GPs, will provide knowledge of the natural history of mild to moderate COVID-19 cases. This may help clinicians and health authorities in better identifying patients with COVID-19. The interview studies will provide valuable information regarding the infection control response during the epidemic as experienced from primary care and municipalities.

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HELSEVEL-Gode og effektive helse-, omsorgs- og velferdstjenester