Concerns, Healthcare Use, and Treatment Interruptions in Patients With Common Autoimmune Rheumatic Diseases During the COVID-19 Pandemic

George, Michael; Venkatachalam, Shilpa; Banerjee, Shubhasree; Baker, Joshua F.; Merkel, Peter A.; Gavigan, Kelly; Curtis, D. R.; Danila, Maria I.; Curtis, Jeffrey R.; Nowell, W. Benjamin

doi:10.3899/jrheum.201017

Cited by 63 publications

(84 citation statements)

References 14 publications

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“…We found that 10% of patients receiving immunomodulatory medications had stopped one of their medications because of concerns about COVID‐19, even if they were well with no COVID‐19 diagnosis or respiratory illness. Most medication interruptions were not recommended by a physician, similar to results from previous studies (10–12,22,23). Guidance from the American College of Rheumatology recommends not stopping medications unless patients have contracted or been exposed to severe acute respiratory syndrome coronavirus 2, although this guidance was first published in April 2020 and was not available when many patients answered their surveys (24).…”

Section: Discussionsupporting

confidence: 85%

“…We also found that patients receiving a biologic or JAKi were more likely to stop a medication (11,27), perhaps reflecting greater concern among this population and the perception that these medications may place patients at higher risk of complications of COVID‐19. Interestingly, older patients were less likely to have stopped medications, even though these patients are at greater risk of severe COVID‐19.…”

Section: Discussionmentioning

confidence: 81%

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Social Distancing, Health Care Disruptions, Telemedicine Use, and Treatment Interruption During the COVID‐19 Pandemic in Patients With or Without Autoimmune Rheumatic Disease

George

Baker

Banerjee

et al. 2021

ACR Open Rheumatology

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Background We aimed to compare concerns, social distancing, health care disruptions, and telemedicine use in patients with autoimmune rheumatic disease (ARD) and non‐ARD and to evaluate factors associated with immunomodulatory medication interruptions. Methods Patients in a multistate community rheumatology practice network completed surveys from April 2020 to May 2020. Adults with common ARD (rheumatoid arthritis, spondyloarthritis, systemic lupus erythematosus) or non‐ARD (gout, osteoarthritis, osteoporosis) were evaluated. Concerns about coronavirus disease 2019 (COVID‐19), social distancing, health care disruptions, and telemedicine use were compared in patients with ARD versus non‐ARD, adjusting for demographics, rural residence, and zipcode‐based measures of socioeconomic status and COVID‐19 activity. Factors associated with medication interruptions were assessed in patients with ARD. Results Surveys were completed by 2319/36 193 (6.4%) patients with non‐ARD and 6885/64 303 (10.7%) with ARD. Concerns about COVID‐19 and social distancing behaviors were similar in both groups, although patients receiving a biologic or Janus kinase (JAK) inhibitor reported greater concerns and were more likely to avoid friends/family, stores, or leaving the house. Patients with ARD were less likely to avoid office visits (45.2% vs. 51.0%, odds ratio [OR] 0.79 [0.70‐0.89]) with similar telemedicine use. Immunomodulatory medications were stopped in 9.7% of patients with ARD, usually (86.9%) without a physician recommendation. Compared with patients with an office visit, the likelihood of stopping medication was higher for patients with a telemedicine visit (OR 1.54 [1.19‐1.99]) but highest for patients with no visits (OR 2.26 [1.79‐2.86]). Conclusion Patients with ARD and non‐ARD reported similar concerns about COVID‐19 and similar social distancing behaviors. Missed office visits were strongly associated with interruptions in immunomodulatory medication.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 81%

Social Distancing, Health Care Disruptions, Telemedicine Use, and Treatment Interruption During the COVID‐19 Pandemic in Patients With or Without Autoimmune Rheumatic Disease

George

Baker

Banerjee

et al. 2021

ACR Open Rheumatology

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“…2). Previous chronic conditions, such as hypertension, 26 arthritis, 27 cancer, 28 epilepsy, 29 and neurodevelopmental disorders in children, 30 were the clinical topics of the investigations. The following factors were repeatedly observed: elderly, 31 women, 28,32 blacks, 26 and mental health of immigrants.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

COVID-19 Remote Consultation Services and Population in Health Inequity-Concentrating Territories: A Scoping Review

Silva

Síndico

Carneiro³

et al. 2021

Telemedicine and e-Health

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Background: This review aimed to map initiatives for measuring the satisfaction of vulnerable populations with teleconsultation services offered by public and private health care providers in their territories, during the coronavirus disease (COVID-19) pandemic. Systematic studies on the opinions of people most affected by health inequities are limited. Therefore, we included evaluations of teleconsultation-based services offered to socioeconomically disadvantaged and clinically vulnerable populations globally, with a focus on surveillance, treatment, and prevention of COVID-19. Materials and Methods: This review includes analytical and descriptive observational studies primarily from MEDLINE, EMBASE, SCOPUS, and Web of Science databases, published after the World Health Organization received the first warnings about COVID-19 from Chinese authorities in December, 2019, until December 2020. The search strategy combined aspects of COVID-19, telemedicine, patient satisfaction, and key concepts of vulnerable populations. Results:We selected 33 studies for full-text reading and 10 for critical appraisal. Two categories emerged from the qualitative analysis: telehealth evaluation and services during COVID-19, and opinions of vulnerable populations. Television and social networks play a crucial role in providing information. Although teleconsultations are practical and cost effective for patients, the majority preferred receiving inperson treatment in primary care clinics. Conclusions: Listening to the opinions of vulnerable groups and their caregivers is critical both before and during adoption of COVID-19 control measures. Health managers need to monitor the health of and delivery of services to socioeconomically and clinically vulnerable people closely, to improve services, and provide care from a human rights perspective.

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“…Concerns, healthcare-related behaviors and psychological impact of COVID-19 pandemic among patients with rheumatic diseases and in particular with SLE have been investigated by several works, reporting a trend towards remarkable psychological distress, however with contrasting results; more specifically, the effect of restrictive measures among the same populations has been less analysed. 15–19 …”

Section: Discussionmentioning

confidence: 99%

Psychological Effects of Lockdown Measures for the COVID-19 Outbreak in Patients with Systemic Lupus Erythematosus

Quartuccio¹,

Marchi²,

Azzolina³

et al. 2021

JMDH

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Objective To compare the psychological impact of the lockdown measures contrasting the COVID-19 outbreak between systemic lupus erythematosus (SLE) and general population. Patients and Methods From July 15th to August 15th 2020, a retrospective survey referring to the period March 9th to May 18th 2020 was administered to SLE patients and the results of the survey, called LEPRE (Lupus Erythematosus PREsto) study, were compared with those from the PRESTO (imPact of quaRantine mEasures againST cOvid19) project, the same survey provided to the general population. Consecutive patients >18 years old affected by SLE and regularly followed in a single rheumatologic centre were involved. Primary outcome was to compare the scores of the Impact of Events Scale-Revised (IES-R), the General Health Questionnaire 12 (GHQ-12) and the Center for Epidemiological Depression Scale (CES-D) between patients and general population. Results A total of 64 patients completed the survey. After a propensity score matching, they were compared to 128 people from PRESTO project. The median age among patients was 43 years (I–III interquartile range 35–54.5), 88% were female and 100% Caucasian. IES-R [(score>23: 57% (34) vs 49% (58)], GHQ-12 [(score>13: 85% (52) vs 88% (106)], and CES-D [(score>15: 45% (28) vs 40% (46)] scores were not statistically different between patients and controls (p>0.05). Conclusion Restrictive measures for COVID-19 pandemic had no greater impact on patients with SLE than in the general population. Strategy for coping to the SLE might be useful during lockdown measures and may be helpful for other chronic conditions.

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Concerns, Healthcare Use, and Treatment Interruptions in Patients With Common Autoimmune Rheumatic Diseases During the COVID-19 Pandemic

Cited by 63 publications

References 14 publications

Social Distancing, Health Care Disruptions, Telemedicine Use, and Treatment Interruption During the COVID‐19 Pandemic in Patients With or Without Autoimmune Rheumatic Disease

Social Distancing, Health Care Disruptions, Telemedicine Use, and Treatment Interruption During the COVID‐19 Pandemic in Patients With or Without Autoimmune Rheumatic Disease

COVID-19 Remote Consultation Services and Population in Health Inequity-Concentrating Territories: A Scoping Review

Psychological Effects of Lockdown Measures for the COVID-19 Outbreak in Patients with Systemic Lupus Erythematosus

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