Perspectives of Patients With Rheumatic Diseases in the Early Phase of COVID‐19

Abstract

Objective To determine health perceptions of patients with rheumatic diseases in the early phase of the coronavirus disease 2019 (COVID‐19) pandemic. Methods Rheumatology patients at a single center received via text message the Australian Rheumatology Association COVID‐19 information sheet and an invitation to participate in a deidentified survey. Patient concerns regarding risks conferred by their rheumatologic disease or medications, impact of receiving the information sheet on the likelihood of staying on medication, and acceptance of telehealth were ascertained. Results A total of 2,630 patients received the text message, and the survey response rate was 21% (n = 550). The mean ± SD age of the participants was 52 ± 15.2 years, and 75.3% were female. Participants’ highest ranked concern was that their medications would increase the severity of their COVID‐19 symptoms (76.1%). The highest levels of concern were seen in patients taking combination conventional synthetic disease‐modifying antirheumatic drugs (DMARDs) and/or a biologic/targeted synthetic DMARD. There was no association between prednisolone dose and concern. While 63% of patients planned to continue their antirheumatic medications, a further 30% were more likely to continue taking their medications because of receiving the information. Telehealth was acceptable to 98.4% of patients, but 28.1% felt this was only appropriate while infection control measures were in place. Conclusion Concerns regarding the risk of COVID‐19 among patients taking antirheumatic drugs are common. Proactive dissemination of information is needed to address misconceptions related to medication risk, improve medication adherence, and minimize the risk of flares. Telehealth is acceptable to most patients during the COVID‐19 pandemic.

Self-protection strategies and health behaviour in patients with inflammatory rheumatic diseases during the COVID-19 pandemic: results and predictors in more than 12 000 patients with inflammatory rheumatic diseases followed in the Danish DANBIO registry

“…Lower quality of life was associated with more anxiety and self-isolation, which reflects the impact of dimensions such as depression and physical impairment. More anxiety in women and patients with comorbidities has previously been demonstrated, 5 18 whereas most studies have been underpowered or have only explored few/no factors associated with healthcare behaviour. 5 7 Previous studies have not confirmed that self-isolation strategies in patients with inflammatory rheumatic diseases cause reduced COVID-19 disease rates.…”

“…Fear of infection has reduced well-being and impacted daily activities including self-isolation strategies. 5 6 Lock-down and lower access to counselling at the rheumatology clinics potentially cause misconceptions regarding medication risk and may induce self-protecting strategies such as non-adherence to DMARDs. 5 7–9 Previous studies of behavioural changes by the use of questionnaire or telephone interview have so far been fairly small (<500–900 patients), monocentric or with low response rates.…”

“… 5 6 Lock-down and lower access to counselling at the rheumatology clinics potentially cause misconceptions regarding medication risk and may induce self-protecting strategies such as non-adherence to DMARDs. 5 7–9 Previous studies of behavioural changes by the use of questionnaire or telephone interview have so far been fairly small (<500–900 patients), monocentric or with low response rates. Few have aimed to identify risk factors for anxiety and self-isolation (eg, diagnosis, gender, age, DMARD use, socioeconomic status), 5 and behavioural changes from the initial phase in March 2020 to the gradual reopening of society are unexplored.…”

“… 5 7–9 Previous studies of behavioural changes by the use of questionnaire or telephone interview have so far been fairly small (<500–900 patients), monocentric or with low response rates. Few have aimed to identify risk factors for anxiety and self-isolation (eg, diagnosis, gender, age, DMARD use, socioeconomic status), 5 and behavioural changes from the initial phase in March 2020 to the gradual reopening of society are unexplored. 9 To understand the full impact of the pandemic on rheumatologic patients, such knowledge is needed to identify risk groups that may need specific information or guidance.…”

ReumaCoV Brasil Registry: Brazilian Study of Patients with Immuno-mediated Chronic Inflammatory Diseases Infected by SARS-CoV-2&nbsp;

“…It is worthy emphasizing this is a complex binomial with many factors involved, such as disease activity, age, comorbidities and drugs, such as glucocorticoids (GCs), conventional synthetic, speci c target or biological disease-modifying anti-rheumatic drugs (csDMARD, stDMARD or bioDMARD, respectively) and immunosuppressants [5]. Considering a possibly poorer evolution of SARS-CoV-2 infection in patients with IMRD, a large amount of questions have been posed regarding the impact of COVID-19 in the beginning of the pandemic, including withdrawal or spacing of medications, hospitalization, need of mechanical ventilation and mortality rate [6][7][8].…”