Healthcare in Crisis: Assessing Medication Adherence, Health Care Access, Telehealth Utilization, and Variations of Depression Treatment in the Era of COVID-19 for US Hypertensive Patients

Abstract

Background: Coronaviruses (CoVs) are highly contagious viruses that cause respiratory and gastrointestinal illnesses. It disrupted global healthcare systems and affected access to care for chronic conditions like hypertension. It is a major risk factor for cardiovascular disease and a leading cause of death in the U.S. However, the pandemic shifted healthcare focus to COVID-19. Telehealth emerged as a critical tool for maintaining continuity of care. The pandemic also intensified mental health issues, such as depression. This study explores medication adherence, healthcare access, telehealth utilization, and depression treatment patterns among U.S. hypertensive patients during COVID 19. Methods: This cross-sectional analysis used secondary data from the Medical Expenditure Panel Survey (MEPS) and the National Health Interview Survey (NHIS).Outcomes included medication adherence among hypertensive patients, telehealth use, healthcare delay during the pandemic, and depression treatment variations in adults with both hypertension and depression. Descriptive statistics were utilized to describe patients’ characteristics, while logistic regression identified predictors of outcomes. Results: Medication adherence varied across antihypertensive classes, with ARBs having the lowest (53.4%) and beta-blockers having the highest (60.6%) levels of adherence. Older adults had lower adherence (adjusted odds ratio (AOR) = 0.87, p < 0.05) compared to younger adults (18-34). Whites were more likely to utilize telehealth than Blacks (AOR = 1.13, P = 0.05). Older individuals faced higher odds of delayed care, with those aged 50–64 having an (AOR = 1.19 ,p = 0.02), and v those aged 65 and above having an (AOR=1.29,p < 0.001). Additionally, Older adults aged 50–64 were more likely to receive depression treatment (AOR: 2.81, p < 0.001), and whites had 2 times higher odds of receiving depression treatment compared to blacks, with a p-value of 0.05. Those with poor physical health had the highest odds of receiving treatment (AOR = 5.99, p < 0.001), compared to those with excellent physical health status. Conclusions: The study highlights disparities in medication adherence, healthcare access, telehealth use, and depression treatment among hypertensive patients during COVID-19. Influenced by age, race, physical health, and gender. These findings highlight the need for policy interventions to improve access to chronic disease care.