scholarly journals The impact of COVID-19 on clinical care, self-management, and mental health of patients with inflammatory arthritis

2021 ◽  
Author(s):  
Melissa Sweeney ◽  
Lewis Carpenter ◽  
Savia de Souza ◽  
Hema Chaplin ◽  
Hsiu Tung ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Emotional Distress ◽  
Inflammatory Arthritis ◽  
Clinical Care ◽  
Care Quality ◽  
Self Management ◽  
Physical And Mental Health ◽  
Disease Outcomes ◽  
The Impact

Abstract Objectives The COVID-19 lockdown and ongoing restrictions in the UK affected access to clinical care, self-management, and mental health for many patients with Inflammatory Arthritis (IA). This study aimed to determine the impact of lockdown on IA clinical care, self-management, disease outcomes, and mental health. Methods In total, 338 people with IA participated in a prospective study completing a series of online questionnaires. The questionnaires assessed demographics, IA condition and management, clinical care, quality of life, and mental health. Visual analogue scales (VAS) were completed at each assessment. Linear regression, controlling for confounders, was conducted to determine factors associated with physical and mental health outcomes. Results Over half of participants reported worsening VAS by more than 10 points for Patient Global Assessment (PGA), pain, fatigue, and emotional distress during the initial lockdown. Changes in clinical care were associated with worse PGA (b = 8.95, p = 0.01), pain (b = 7.13, p = 0.05), fatigue (b = 17.01, p < 0.01) and emotional distress (b = 12.78, p < 0.01). Emotional distress and depression were also associated with worse outcomes in PGA, pain, and fatigue, while loneliness was not. In contrast, physical activity seemed to mitigate these effects. Loneliness did not show any associations with outcomes. Over time, these effects decreased or disappeared. Conclusions Changes to clinical care due to lockdown were associated with worse disease outcomes in patients with IA. There has been a clear impact on mental health as well, with possibly complex relationships between mental health and psychosocial factors. Physical activity emerged as a key influence on disease outcomes and mental health.

scholarly journals P095 The impact of COVID-19 lockdown on clinical care, self-management, and mental health in patients with inflammatory arthritis

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Melissa Sweeney ◽  
Lewis Carpenter ◽  
Savia de Souza ◽  
Hema Chaplin ◽  
Hsiu Tung ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Emotional Distress ◽  
Inflammatory Arthritis ◽  
Clinical Care ◽  
Self Management ◽  
Disease Outcomes ◽  
Reduced Physical Activity ◽  
Vas Scores ◽  
The Impact

Abstract Background/Aims  COVID-19 lockdown affected access to clinical care for many vulnerable patients, including those with inflammatory arthritis (IA). It also had the potential to alter self-management behaviours. These changes could in turn impact mental health, especially given that IA patients are already at higher risk of mental health disorders. Thus, the aims of this study were to determine how IA care and self-management were affected by lockdown and assess the impact of these changes on disease outcomes and mental health. Methods  Online questionnaires were completed by 338 participants between June and July 2020. The questionnaires assessed demographics, IA condition, IA self-management, COVID-19 clinical information, quality of life, and mental health. Visual analogue scale (VAS) scores for patient global assessment (PGA) of disease activity, pain, fatigue, and emotional distress were completed relating to the previous week and retrospectively for pre-lockdown (March) and early-lockdown (April). Improvement/worsening in each VAS was considered as a change of 10 points or more from pre-lockdown to the current rating. Linear regressions were conducted to determine factors associated with worse outcomes, controlling for potential confounders including self-reported pre-lockdown status. Results  Mean VAS scores worsened during lockdown for all outcome measures, with over half reporting a more than 10-point worsening (Table 1). Changes to clinical care affected 87% of patients. The most commonly affected services were hospital outpatient appointments (77%), GP appointments (59%), and blood tests (53%). Changes to clinical care were significantly associated with worse PGA (b = 8.95, p=0.01), pain (b = 7.13, p=0.05), fatigue (b = 17.01, p<0.00) and emotional distress (b = 12.78, p<0.01). Regarding self-management, 64% of patients reported changes to diet while 51% reduced physical activity. Change in diet was not significantly associated with any of the outcomes, whereas physical activity was associated with PGA (b=-2.42, p<0.01), pain (b=-2.43, p<0.01), fatigue (b=-2.5, p < 0.01), and emotional distress (b=-2.41, p<0.01). Conclusion  Most patients (87%) had at least one area of clinical care affected by the lockdown. These changes in IA clinical care were associated with worse disease outcomes across all measures and greater emotional distress. In self-management, reduced physical activity was associated with worse outcomes in all physical and mental health measures. P095 Table 1:Mean VAS (0-100) scores and percent changesPGAMarch April June/JulyMean (SD) 44.51 (23.70) 53.18 (24.67) 57.69 (25.29)Better Same WorsePercent 7.9936.6855.33[95% CI] [5.33-11.41][31.54-42.07][49.85-60.71]PainMarch April June/July42.60 (25.60) 51.11 (26.01) 56.66 (26.40)Better Same Worse7.6937.8754.44[5.09-11.07] [32.68-43.28][48.96-59.84]FatigueMarch April June/July46.86 (26.17) 57.11 (25.83) 61.35 (26.51)Better Same Worse10.0634.0255.92[7.07-13.77] [28.98-39.35][50.44-61.29]Emotional DistressMarch April June/July30.96 (26.28) 49.06 (29.09) 48.75 (29.15)Better Same Worse8.2833.14 58.58[5.58-11.75] [28.14-38.43][53.12-63.88] Disclosure  M. Sweeney: None. L. Carpenter: None. S. de Souza: None. H. Chaplin: None. H. Tung: None. E. Caton: None. J. Galloway: None. A. Cope: None. M. Yates: None. S. Norton: None.

scholarly journals Physical, cognitive and mental health impacts of COVID-19 following hospitalisation: a multi-centre prospective cohort study

2021 ◽  
Author(s):  
Rachael Andrea Evans ◽  
Hamish McAuley ◽  
Ewen M Harrison ◽  
Aarti Shikotra ◽  
Amisha Singapuri ◽  
...  
Keyword(s):  
Mental Health ◽  
Clinical Care ◽  
Acute Illness ◽  
Physical And Mental Health ◽  
White Ethnicity ◽  
Reactive Protein ◽  
Active Approach ◽  
Health Related ◽  
Biochemical Testing ◽  
The Impact

Background The impact of COVID-19 on physical and mental health, and employment following hospitalisation is poorly understood. Methods PHOSP-COVID is a multi-centre, UK, observational study of adults discharged from hospital with a clinical diagnosis of COVID-19 involving an assessment between two- and seven-months later including detailed symptom, physiological and biochemical testing. Multivariable logistic regression was performed for patient-perceived recovery with age, sex, ethnicity, body mass index (BMI), co-morbidities, and severity of acute illness as co-variates. Cluster analysis was performed using outcomes for breathlessness, fatigue, mental health, cognition and physical function. Findings We report findings of 1077 patients discharged in 2020, from the assessment undertaken a median 5 [IQR4 to 6] months later: 36% female, mean age 58 [SD 13] years, 69% white ethnicity, 27% mechanical ventilation, and 50% had at least two co-morbidities. At follow-up only 29% felt fully recovered, 20% had a new disability, and 19% experienced a health-related change in occupation. Factors associated with failure to recover were female, middle-age, white ethnicity, two or more co-morbidities, and more severe acute illness. The magnitude of the persistent health burden was substantial and weakly related to acute severity. Four clusters were identified with different severities of mental and physical health impairment: 1) Very severe (17%), 2) Severe (21%), 3) Moderate with cognitive impairment (17%), 4) Mild (46%), with 3%, 7%, 36% and 43% feeling fully recovered, respectively. Persistent systemic inflammation determined by C-reactive protein was related to cluster severity, but not acute illness severity. Interpretation We identified factors related to recovery from a hospital admission with COVID-19 and four different phenotypes relating to the severity of physical, mental, and cognitive health five months later. The implications for clinical care include the potential to stratify care and the need for a pro-active approach with wide-access to COVID-19 holistic clinical services. Funding: UKRI and NIHR

scholarly journals PROMOTING PHYSICAL ACTIVITY AMONG AT-RISK OLDER ADULTS: THE IMPACT FROM PHYSICAL AND MENTAL HEALTH

2018 ◽  
Vol 2 (suppl_1) ◽  
pp. 742-743
Author(s):  
M Ory ◽  
S Towne ◽  
Y Du ◽  
S Lee ◽  
M Smith
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Older Adults ◽  
At Risk ◽  
Physical And Mental Health ◽  
The Impact

scholarly journals O25 The impact of COVID-19 lockdown on mental health and quality of life in patients with inflammatory arthritis

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Melissa Sweeney ◽  
Lewis Carpenter ◽  
Savia de Souza ◽  
Hema Chaplin ◽  
Hsiu Tung ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Physical Health ◽  
Emotional Distress ◽  
Inflammatory Arthritis ◽  
Mental Health Disorder ◽  
Online Questionnaire ◽  
Health Measures ◽  
The Impact

Abstract Background/Aims  COVID-19 lockdown has affected the mental health of many people around the world. People with inflammatory arthritis (IA) are at a higher risk of mental health and psychosocial consequences of the pandemic compared with the general population, since they are potentially more vulnerable to COVID-19 and experience higher rates of existing comorbid mental health disorder. Furthermore, vulnerable patients were advised to self-isolate for 12 weeks, which could further exacerbate emotional distress. This study aimed to explore the impacts of lockdown on mental health and wellbeing, and to determine which factors were associated with worse disease outcomes. Methods  An online questionnaire was completed by 338 participants in the UK with an IA condition between June and July 2020. The questionnaire, designed with input from a service user, assessed various aspects of the impact of the pandemic on the quality of life of people with IA, including their mental health. Self-reported visual analogue scales (VAS) for patient global assessment (PGA) of disease activity, pain, fatigue, and emotional distress were completed relating to the previous week, and retrospectively for pre-lockdown (March) and early-lockdown (April). Specific mental health outcomes were further captured using the 8-item Patient Health Questionnaire (PHQ8) and the short UCLA loneliness scale. Linear regressions were conducted to determine mental health factors associated with worse outcomes on physical health measures (PGA, pain, and fatigue), controlling for fear of COVID-19 and COVID-19 status. Results  Overall, 49% of participants met the PHQ8 criteria for moderate to severe depressive symptoms and 58% reported their mental health had worsened by more than 10 points on the emotional distress VAS during lockdown. Finally, 37% reported they were concerned about loneliness, with 26% indicating this had worsened during lockdown. Emotional distress VAS was significantly associated with PGA (b = 0.21, p< 0.01), pain (b = 0.24, p<0.01), and fatigue (b = 0.36, p<0.01). Similarly, depression was also associated with PGA (b = 0.95, p<0.01), pain (b = 0.92, p<0.01), and fatigue (b = 1.56, p<0.01). However, loneliness was not associated with any of the physical health VAS scores but was associated with the emotional distress VAS (b = 1.83, p=0.00). These results remained consistent for emotional distress, depression, and loneliness as predictors when accounting for fear of COVID-19 and COVID-19 status. Conclusion  There has been a clear impact of the pandemic on the mental health of people with IA, and this should be taken into consideration by clinicians, especially as it appears to be related to worse overall reported physical health. The mixed results for loneliness in comparison to other mental health measures may illustrate the inter-relatedness of these aspects of mental and physical health, particularly in the context of lockdown. Disclosure  M. Sweeney: None. L. Carpenter: None. S. de Souza: None. H. Chaplin: None. H. Tung: None. E. Caton: None. J. Galloway: None. A. Cope: None. M. Yates: None. S. Norton: None.

scholarly journals School Parks as a Community Health Resource: Use of Joint-Use Parks by Children before and during COVID-19 Pandemic

2021 ◽  
Vol 18 (17) ◽  
pp. 9237
Author(s):  
Kevin Lanza ◽  
Casey Durand ◽  
Melody Alcazar ◽  
Sierra Ehlers ◽  
Kai Zhang ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Resource Use ◽  
Social Distance ◽  
Negative Binomial ◽  
Negative Binomial Regression ◽  
Health Resource ◽  
Physical And Mental Health ◽  
Binomial Regression ◽  
The Impact

Parks are settings for physical activity that can support the physical and mental health of children during the COVID-19 pandemic. We determined the impact of the pandemic on the use of joint-use parks outside of school hours by children in Austin, TX, United States. In autumn of 2019 and autumn of 2020 (i.e., before and during the COVID-19 pandemic), we used an adapted version of the System for Observing Play and Recreation in Communities to observe whether children aged 1–12 participated in physical activity (i.e., sedentary, light and moderate, vigorous) at three parks located at schools serving mostly economically disadvantaged Latinx families. In 2020, we also observed whether children maintained social distance and wore face coverings. Results of negative binomial regression modeling revealed the pandemic was associated with a 46% [95% CI: 20–63%] and 62% [95% CI: 39–76%] decrease in the number of girls and boys at parks, respectively, and a 42% [95% CI: 16–59%] and 60% [95% CI: 36–75%] decrease in the number of girls and boys engaging in physical activity, respectively (p < 0.01). In total, 60.6% of girls and 73.6% of boys were not social distancing, and 91.8% of the time no children wore masks. Interventions should be considered to safely reintroduce children to parks for health benefits during pandemics.

Self-management of fear due to the Covid-19 pandemic and the changes it has brought to the everyday life (Preprint)

2021 ◽  
Author(s):  
Chrisi Vlachou ◽  
Alexandros Argyriadis ◽  
Agathi Argyriadi
Keyword(s):  
Mental Health ◽  
Social Life ◽  
Family Members ◽  
Structured Interview ◽  
Self Management ◽  
Physical And Mental Health ◽  
Her Family ◽  
The Third ◽  
Informed Consent Form ◽  
The Impact

BACKGROUND The recent pandemic of the new coronavirus, COVID-19, has had financial and social repercussions apart from its consequences to the physical and mental health of humans. OBJECTIVE The aim of this work was to study the way of the self-management of stress and fear which has been caused by the pandemic crisis, as well as the impact of the pandemic on daily living. More specifically, the factors which influenced the management of the symptoms of fear, either in a positive or in a negative way, were studied, and also the ways individuals and their families use to manage fear. METHODS The method which was used was the case study of an adult female who lives and works in a Greek town, during the third curfew, in March 2021. The tool which was used for data collection was the semi-structured interview, by utilizing a questionnaire consisting of 10 open-ended questions. Before the start of the interview, a signed informed consent form was obtained. The questions were divided into three topic areas, with the first concerning the demonstration of stress before the pandemic broke out, the second concerning the fear during the pandemic, and the third dealing with the ways of managing fear, the availability of persons capable of helping, as well as the kind of help she could have sought to cope with this situation. RESULTS The results of this study showed the impact of the curfew restrictions for the management of the pandemic on the daily lives of the people who experience them. Before the start of the pandemic, stress was primarily related to work and to the need of maintaining a routine. Public fear intensified during the pandemic and the lockdown, both in relation to work and in relation to the pandemic itself, and also in relation to its effects on work and social life, and certainly on physical and mental health. Her stress affected the rest of her family members; however, her social network proved to be a significant support. CONCLUSIONS Stress and fear increased during the pandemic and the lockdown which was imposed in Greece in order to prevent the spread of COVID-19. This stress, which prior to the pandemic was focused mainly on work-related issues, spread to other areas of daily life, a fact that affected all the family members. Discussions and support from the husband, and also from the wider circle of family and friends, helped deal with and manage the situation which was caused by the pandemic, due to the special living conditions which were in force.

scholarly journals Changes in Care- A Systematic Scoping Review of Transitions for Children with Medical Complexities

2020 ◽  
Vol 16 (3) ◽  
pp. 165-175
Author(s):  
Tara Mantler ◽  
Kimberley T. Jackson ◽  
Jessi Baer ◽  
Jenna White ◽  
Bridget Ache ◽  
...  
Keyword(s):  
Mental Health ◽  
Outcome Measures ◽  
Emotional Distress ◽  
Scoping Review ◽  
Emotional Health ◽  
Models Of Care ◽  
Physical And Mental Health ◽  
High Expectations ◽  
Transitions In Care ◽  
The Impact

Background: Children with medical complexity (CMC) and their parents are affected physically and mentally during transitions in care. Coordinated models of care show promise in improving health outcomes. Objective: The purpose of this scoping review was to examine research related to CMC and their parents and transitions in care. The aim was 3-fold: (1) to examine the extent, range, and nature of research activity related to the impact of transitions on physical and mental health for CMC and their parents; (2) to summarize and disseminate research findings for key knowledge users; and (3) to identify research gaps in the existing literature to inform future studies. Methods: Twenty-three sources were identified through database searches and five articles met the inclusion criteria of CMC (multi-organ involvement or technology-dependent) (or parents of CMC) transitioning from hospital to alternate levels of care where outcome measures were physical or mental health-related. Results: Numerical analysis revealed substantial variation in methodological approaches and outcome measures. Content analysis revealed two themes for parents of CMC during this transition: (1) emotional distress, and (2) high expectations; and three themes for CMC: (1) improved health, (2) changes in emotion, and (3) disrupted relationships. Conclusion: The findings from this scoping review reveal for parents, transitions in care are fraught with emotional distress and high expectations; and for CMC there are improvements in quality of life and emotional health post- hospital to home transitions when collaborative models of care are available. This review serves as an early attempt to summarize the literature and demonstrate a need for further research.

scholarly journals COVID-19 as ‘Game Changer’ for the Physical Activity and Mental Well-Being of Augmented Reality Game Players During the Pandemic: Mixed Methods Survey Study (Preprint)

2020 ◽  
Author(s):  
Louise A Ellis ◽  
Matthew D Lee ◽  
Kiran Ijaz ◽  
James Smith ◽  
Jeffrey Braithwaite ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Video Games ◽  
Video Game ◽  
Well Being ◽  
Harry Potter ◽  
Physical And Mental Health ◽  
Pokémon Go ◽  
The Impact ◽  
Mental Well Being

BACKGROUND Location-based augmented reality (AR) games, such as Pokémon GO and Harry Potter: Wizards Unite, have been shown to have a beneficial impact on the physical activity, social connectedness, and mental health of their players. In March 2020, global social distancing measures related to the COVID-19 pandemic prompted the AR games developer Niantic Inc to implement several changes to ensure continued player engagement with Pokémon GO and Harry Potter: Wizards Unite. We sought to examine how the physical and mental well-being of players of these games were affected during the unprecedented COVID-19 restriction period as well as how their video game engagement was affected. OBJECTIVE The aims of this study were to examine the impact of COVID-19–related social restrictions on the physical and mental well-being of AR game players; to examine the impact of COVID-19–related social restrictions on the use of video games and motivations for their use; and to explore the potential role of AR games (and video games in general) in supporting well-being during COVID-19–related social restrictions. METHODS A mixed methods web-based self-reported survey was conducted in May 2020, during which COVID-19–related social restrictions were enforced in many countries. Participants were recruited on the web via four subreddits dedicated to Pokémon GO or Harry Potter: Wizards Unite. Data collected included quantitative data on demographics, time spent playing video games, physical activity, and mental health; qualitative data included motivations to play and the impact of video games on mental health during COVID-19 lockdown. RESULTS We report results for 2004 participants (1153/1960 male, 58.8%, average age 30.5 years). Self-reported physical activity during COVID-19–related social restrictions significantly decreased from 7.50 hours per week on average (SD 11.12) to 6.50 hours (SD 7.81) (<i>P</i>&lt;.001). More than half of the participants reported poor mental health (925/1766, 52.4%; raw World Health Organization–5 Well-Being Index score &lt;13). Female gender, younger age, and reduced exercise were significant predictors of poor mental health. Participants reported a significant increase in video game play time from 16.38 hours per week on average (SD 19.12) to 20.82 hours (SD 17.49) (<i>P</i>&lt;.001). Approximately three quarters of the participants (n=1102/1427, 77.2%) reported that playing video games had been beneficial to their mental health. The changes made to Pokémon GO and Harry Potter: Wizards Unite were very well received by players, and the players continued to use these games while exercising and to maintain social connection. In addition to seeking an escape during the pandemic and as a form of entertainment, participants reported that they used video games for emotional coping and to lower stress, relax, and alleviate mental health conditions. CONCLUSIONS AR games have the potential to promote physical and mental health during the COVID-19 pandemic. Used by populations under isolation and distress, these games can improve physical and mental health by providing virtual socialization, sustained exercise, temporal routine, and mental structure. Further research is needed to explore the potential of AR games as digital behavioral interventions to maintain human well-being in the wider population.

scholarly journals Change in Perceived Stress and Health Behaviors of Emerging Adults in the Midst of the COVID-19 Pandemic

2021 ◽  
Author(s):  
Lara J LaCaille ◽  
Stephanie A Hooker ◽  
Elaine Marshall ◽  
Rick A LaCaille ◽  
Rhea Owens
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Health Behaviors ◽  
Emerging Adults ◽  
Perceived Stress ◽  
First Year ◽  
Physical And Mental Health ◽  
First Year Of College ◽  
The Impact ◽  
Over Time

Abstract Background The COVID-19 pandemic has resulted in unprecedented disruptions, restrictions, and concerns about physical and mental health. Emerging adulthood, including the first year of college, is associated with declines in healthy eating and physical activity, as well as possible heightened distress. The impact of COVID-19 may exacerbate these concerns. Purpose The purpose of this study was to examine changes in health behaviors and perceived stress in emerging adults over the first year of college and to determine whether prepandemic health behaviors were protective for mental health and stress during the initial changes after the COVID-19 pandemic. Methods First-year college students (N = 234, 58.6% female) completed three surveys during their first year of school, the third being after the onset of COVID-19 and during a stay-at-home order. At Time 3, we also assessed symptoms of anxiety and depression. Results Using linear mixed modeling, sedentary time increased and physical activity decreased over time, but 20%–35% of students reported improvements in these behaviors. Dietary changes appeared mixed, with some improvements noted early during COVID-19. Perceived stress increased over time. Multiple regression indicated that of the health behaviors examined for protective effects on mental health and stress during the pandemic, only diet quality emerged as a significant predictor. Conclusions Although notable declines in some health habits were observed over time, including following COVID-19 disruptions, some students reported improved health behaviors. Efforts should be directed at identifying and intervening with students most at risk for poor functioning.

scholarly journals P068 Exploring the impact of COVID-19 on self-management and healthcare provision in people with Inflammatory Arthritis: A qualitative study

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Emma Caton ◽  
Hema Chaplin ◽  
Lewis Carpenter ◽  
Melissa Sweeney ◽  
Hsiu Tung ◽  
...  
Keyword(s):  
Physical Activity ◽  
Inflammatory Arthritis ◽  
Negative Impact ◽  
Survey Study ◽  
Self Management ◽  
Baseline Survey ◽  
Severe Illness ◽  
Healthcare Provision ◽  
The Uk ◽  
The Impact

Abstract Background/Aims  Inflammatory arthritis (IA) patients have been identified as being at greater risk of severe illness from COVID-19. It is likely that lockdown restrictions enforced by the UK government in response to the COVID-19 pandemic, and subsequent changes made to healthcare provisions, could impact patients’ abilities to effectively manage their condition. The aim of this study was to qualitatively explore the impact of COVID-19 and lockdown on self-management behaviours and healthcare provision in people with IA. Methods  Semi-structured interviews were conducted with 21 patients with IA from across the UK (as part of a larger longitudinal survey study exploring the impact of COVID-19 on health-related quality of life for people with IA). Participants who gave consent for contact, following the completion of the baseline survey study, were approached to take part in the qualitative interviews. The interview schedule was developed with a Patient Research Partner and consisted of eight main questions to explore participants’ experiences of the COVID-19 pandemic, including the impact of COVID-19 on their self-management behaviours and access to healthcare services. The interviews were conducted via telephone and were recorded and transcribed before being analysed using inductive thematic analysis. Results  Participants were aged between 24-72 (mean age 50.0, SD 15.6) and were mostly female (71%) and White British (86%). Four main themes were identified: impact of COVID-19 on medication adherence, impact of COVID-19 on physical activity, impact of COVID-19 on diet, and impact of COVID-19 on healthcare access. Subthemes focused on positive and negative changes made to these areas, as well as behaviours which remained consistent. Some participants expressed that the lockdown period had enabled them to increase their physical activity, improve their diet and maintain their usual medication regimen, whilst others noted that lockdown had had a negative impact on their self-management behaviours. For example, some patients decided to discontinue their medication during the pandemic due to concerns that it would make them more susceptible to severe consequences from COVID-19. In relation to healthcare provision, the most commonly reported change was the introduction of telephone appointments to replace face-to-face consultations. Several patients found the telephone appointments ineffective, especially if their disease was relatively uncontrolled. Nevertheless, participants understood why a remote approach had been implemented during the pandemic. Conclusion  COVID-19 has had an impact on patients’ abilities to manage their IA. Healthcare professionals need to recognise the impact of COVID-19 on patient self-management and healthcare provision to ensure that adequate understanding and support is available to patients who may have inadequate disease control as a result. Disclosure  E. Caton: None. H. Chaplin: None. L. Carpenter: None. M. Sweeney: None. H. Tung: None. S. de Souza: None. S. Norton: None.

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