BACKGROUND: The COVID-19 pandemic posed severe challenges to delivery of services at Primary Care level and for achieving follow-up of patients with chronic diseases. OBJECTIVES: We analysed data from the PRICOV-19 study to explore determinants of active follow-up for chronic disease patients in seven Central and Eastern European (CEE) countries during the pandemic. METHODS: Pricov-19 was a cross-sectional study conducted within PC (Primary Care) practices in 37 European countries. We analysed data from 7 CEE countries (Bulgaria, Czech Republic, Hungary, Poland, Moldova, Romania, Ukraine) collected between November 2020 and December 2021. Practices were recruited through random or convenience sampling and participation of practices was voluntary. We performed descriptive statistics to identify the level of follow-up of chronic disease and what health system and practice-specific factors were associated with better follow-up. We used logistic regression and meta-analysis techniques to explore associations and heterogeneity between countries. RESULTS: 67.8% out of 978 practices reported actively following up chronic patients. Positive associations were found between active follow-up and such as having more GPs (aOR = 1.18, p-value = 0.005), an above-average chronic patient population (aOR = 3.13, p-value = 0.006), adequate government support (aOR = 2.35, p-value = 0.001), and GPs having time for guideline reading (aOR = 0.008, p-value = 1.71). CONCLUSIONS: Patient follow-up, was influenced by different health system and practice-specific factors. The implications suggest the need for government support to enhance PC practice organisation during crises and solutions to decrease GP workload and provide tailored care for patients with chronic disease.

In 7 Central and Eastern European countries, 68% of PC practices effectively followed-up patients with chronic conditions during the pandemic.Key determinants for successful follow-up included government support, GP time availability, and staffing levels of GPs.Video consultations and payment mechanisms did not show significant associations with optimal patient follow-up.

Department of Family Medicine Jagiellonian University Medical College Krakow Poland

Department of Family Medicine Nicolae Testemitanu Chișinău Moldova

Department of Family Medicine Semmelweis University Budapest Hungary

Department of Family Medicine Shupyk National Medical Academy of Postgraduate Education Kiev Ukraine

Department of General Medicine Plovdiv University Plovdiv Bulgaria

Department of Kinetic Therapy and Special Motricity Spiru Haret University Bucharest Romania

Department of Public Health and Primary Care Ghent University Ghent Belgium

Healthy Life Project Reducing the Burden of Non Communicable Diseases in Moldova Swiss Agency for Development and Cooperation Chișinău Moldova

Institute of General Practice 1st Faculty of Medicine Charles University Prague Czech Republic

Irish College of General Practitioners Dublin Ireland

Mother and Child Institute Chișinău Moldova

Quality and Safety Ghent University Ghent Belgium

Swiss Tropical and Public Health Institute Allschwil Switzerland

University of Basel Basel Switzerland

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