Impact of COVID-19 Pandemic on Rheumatology Practice in Latin America

Abstract

Objective To describe the impact of COVID-19 pandemic on Latin American rheumatologists from a professional, economic, and occupational point of view. Methods We conducted an observational cross-sectional study using an online survey sent to rheumatologists of each non-English-speaking country member of the Pan American League of Rheumatology Associations (PANLAR). A specific questionnaire was developed. Results Our survey included 1097 rheumatologists from 19 Latin American countries. Median (IQR) age of respondents was 48 (40-59) years and 618 (56.3%) were female. Duration of practice since graduation as rheumatologist was 17 years, and 585 (53.3%) were under 50 years of age. Most rheumatologists worked in private practice (81.8%) and almost half worked in institutional outpatient centers (55%) and in-patient care (49.9%). The median number of weekly hours (IQR) of face-to-face practice before the pandemic was 27 (15-40) but it was reduced to 10 (5- 20) during the pandemic. Telehealth was used by 866 (78.9%) respondents during the pandemic. Most common methods of communication were video calls (555; 50.6%), telephone calls (499; 45.5%) and WhatsApp voice calls (423; 38.6%). A reduction in monthly wages was reported by 946 (86.2%) respondents. Consultation fees also were reduced and 88 (8%) rheumatologists stated they had lost their jobs. A reduction in patient adherence to medication was reported by nearly 50% of respondents. Eighty-one (7.4%) rheumatologists received a COVID-19 diagnosis and 7 (8.6%) of them were hospitalized. Conclusion COVID-19 pandemic has reshaped rheumatology practice in Latin America and has had a profound impact on rheumatologists' behaviors and clinical practice.

Impact of COVID-19 pandemic on the management of patients with RA: a survey of rheumatologists in six European countries

“…This is potentially supported by our finding that German physicians believed that management changes would not persist, because changes might have begun to revert by the time of our survey. Surveys in Latin America and the UK that showed similar telemedicine utilization during the pandemic to our study showed that lower proportions of rheumatologists believed that telemedicine would continue [ 22 , 23 ]. In particular, a UK study conducted during August–December 2020 showed that the majority of rheumatologists believed that <50% of follow-up appointments post-pandemic would be conducted remotely; although still high, this could potentially indicate a cooling of opinions about telemedicine after the initial pandemic peak [ 22 ].…”

Changes in Service Delivery and Access to Rheumatologists Before and During the COVID-19 Pandemic in a Canadian Universal Healthcare Setting

“…[9][10][11] Moreover, direct faceto-face patient encounters in Latin America declined during pandemic-related public health mandates. 12 The pandemic has also led to a shift in healthcare delivery methods, with the expansion of telemedicine. 13 One study from the US reported an increase in telemedicine uptake within rheumatology to 41.4% of all follow-up encounters early in the pandemic.…”

Impacto de la pandemia por SARS-CoV-2 en la formación de los alumnos de la Carrera de Médico Especialista en Reumatología

“…En un estudio de Fernández-Ávila et al, donde se encuestaron a 1.097 reumatólogos de 19 países de América Latina, con un 81,8% de los participantes perteneciente al ámbito privado, se informó una reducción de casi el 60% en las jornadas presenciales de trabajo, con una fuerte impronta de la telemedicina desarrollada por el 78% de los encuestados. Dentro de las diferentes tecnologías mencionadas, las más frecuentes fueron: las videoconsultas (50,6%), las consultas telefónicas (45,5%) y la mensajería electrónica (Whatsapp en un 38,5%) 8 .…”