Objective: To describe sustainability of low disease activity levels in patients with rheumatoid arthritis (RA) who were followed-up in a specialized center based on a healthcare model maintaining adherence to appointments and treatment.Material and methods: As part of a comprehensive RA healthcare model, services related to care like rheumatology, physiatry, physiotherapy, occupational therapy, nutrition, and psychology can be found in the specialized center. Patients with RA are followed-up at least six times a year to ensure retention in care model and adherence to the treatment. Using this approach, a cohort of RA patients were followed-up during 2018. Demographical and clinical data were extracted retrospectively from the electronic health records. The association between clinical and demographic variables was studied by means of the Chi-square test and analyzed using the McNemar test for changes in disease activity levels. Results: 2,239 RA patients were followed-up, 82.76% were women. The average disease duration was eight years (IQR: 3-18 years). During the follow-up year, 91.62% of patients with conventional therapy had at least six rheumatology appointments, while for those who received biological therapy 81.51%. For the ones treated with biological therapy, there were no significant changes for each level of disease activity during study period; nevertheless, in patients who received conventional therapy there was a significant increase of patients in remission (p-value = 0.004).Conclusions: The results evidence that the model used guarantees high levels of adherence for medical appointments and keeps remission levels for RA under control.
Background:Rheumatoid arthritis (RA) is a high-cost disease, usually diagnosed at a productive age in life. RA brings significant changes in a patient’s life. On an emotional level, the patient perceives a strong impact that generates disorientation, denial, depression, hopelessness, anger and fear due to the uncertainty of the development of the disease and the doubt of the turn that his life will take. However, each patient has different ways of coping with the disease and adapting to it (1,2). These changes require attention from health personnel. In this regard, different studies have reported the effect of educational, support and empowerment programs for patients on reducing the effects of the disease and the benefits are oriented towards improving lifestyles by improving self-care (3,4).Objectives:To describe the experience of patients with rheumatoid arthritis, their perception and expectations about entering a multicomponent educational program in a specialized center in Bogotá - Colombia.Methods:For this study a concurrent mixed design was used, in which quantitative and qualitative methods are applied simultaneously, we invited patients with rheumatoid arthritis who attended a specialized center in Bogotá - Colombia who enrolled in an education program called UNIVERSITAR. The quantitative phase included a descriptive analysis and the application of the expectations scale adapted from Borkovec and Nau (5); this scale collects information about the level of expectations and satisfaction of the program. The scale ranges from 0 (not at all) to 10 (very much). Immediately after the application of the scale, the participants were invited to a focus group that allowed the dialogue on the perception and expectations of the participants regarding the program, through a dynamic process in which the participants exchanged their ideas and opinions. A group interview script was used, aimed at identifying the patients’ experiences with their diagnosis and their expectations regarding the program. Two focus groups were held with an average duration of one hour; the discussion was recorded on audio and transcribed in its entirely.Results:We included 31 participants and were distributed in two focus groups. The median age of the participants was 60 years IQR (54-67), 92% were female. 77% of participants reported high scores for the satisfaction regarding the program. In the qualitative phase two categories emerged that speak of the experience of the participants with the disease. They highlighted the appearance of this disease in their lives in an unexpected way, the doubts and uncertainties that were generated from the diagnosis and the implications that this condition causes health in their everyday life. However, in the second category, the expectations and motivations of the participants towards the educational program are highlighted, and the factors that influence their participation and their motivation to train and empower themselves to make decisions and as expert patients, capable of educate, guide and support other patients with the same diagnosis.Conclusion:The expectations and perceptions of the patients are of great importance, since through these the conditions with which these educational programs provide interventions and a better quality of life to these patients can be improved.Disclosure of Interests:None declared
Background: To describe the practices and behaviors of patients with rheumatoid arthritis (RA) who attend to a face-to-face education program, during the quarantine of the COVID-19 pandemic. Methods: Patients who attended previously a face-to-face education program, responded to a telephonic survey in July 2020. The survey included questions about their practices related to the COVID-19 pandemic, SARS-Cov-2 symptoms, adherence to rheumatoid arthritis treatment, virtual rheumatology consultancy compliance and, the influence of news on their adherence. Results: A total of 260 patients participated in a survey. In July 2020 88% of patients had accessed a telemedicine-based and 12% a face-to-face rheumatology consultation. 3.5% of patients reported having been less adherent to pharmacological therapy due to information received through media or social networks. In general patients had been compliant with COVID-19 prevention recommendations. Only one patient was positive for SARS-CoV-2 and reported only flu symptoms without any complications. Patients highlighted the necessity to have information and education about the relationship between rheumatoid arthritis, its treatment, and COVID-19. Conclusions: An educational program is a helpful tool to maintain high adherence rates to the RA treatment despite of the new challenges associated to the pandemic; Patient-centered education programs should continue to address the patient's concerns and beliefs about their disease and COVID-19.
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