Removing barriers and disparities in health: lessons from the COVID-19 pandemic

Sirotich, Emily; Hausmann, J.

doi:10.1038/s41584-020-00524-8

Cited by 8 publications

(12 citation statements)

References 9 publications

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“…Barriers to enrollment of non-white participants in research studies include structural racism and distrust of research given the history of mistreatment of vulnerable individuals. 27 The female predominance in this study probably reflects the increased prevalence of rheumatic diseases in women, as well as the increased participation of women in online studies. 28 Relying on self-reported data, we cannot rule out misclassification of diagnosis or other relevant clinical or demographic data.…”

Section: Discussionmentioning

confidence: 73%

Immediate effect of the COVID-19 pandemic on patient health, health-care use, and behaviours: results from an international survey of people with rheumatic diseases

Kennedy

Moni

Levine

et al. 2021

The Lancet Rheumatology

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Background The impact and consequences of the COVID-19 pandemic on people with rheumatic disease are unclear. We developed the COVID-19 Global Rheumatology Alliance Patient Experience Survey to assess the effects of the COVID-19 pandemic on people with rheumatic disease worldwide.Methods Survey questions were developed by key stakeholder groups and disseminated worldwide through social media, websites, and patient support organisations. Questions included demographics, rheumatic disease diagnosis, COVID-19 diagnosis, adoption of protective behaviours to mitigate COVID-19 exposure, medication access and changes, health-care access and communication with rheumatologists, and changes in employment or schooling. Adults age 18 years and older with inflammatory or autoimmune rheumatic diseases were eligible for inclusion. We included participants with and without a COVID-19 diagnosis. We excluded participants reporting only non-inflammatory rheumatic diseases such as fibromyalgia or osteoarthritis. Findings 12 117 responses to the survey were received between April 3 and May 8, 2020, and of these, 10 407 respondents had included appropriate age data. We included complete responses from 9300 adults with rheumatic disease (mean age 46•1 years; 8375 [90•1%] women, 893 [9•6%] men, and 32 [0•3%] participants who identified as non-binary). 6273 (67•5%) of respondents identified as White, 1565 (16•8%) as Latin American, 198 (2•1%) as Black, 190 (2•0%) as Asian, and 42 (0•5%) as Native American or Aboriginal or First Nation. The most common rheumatic disease diagnoses included rheumatoid arthritis (3636 [39•1%] of 9300), systemic lupus erythematosus (2882 [31•0%]), and Sjögren's syndrome (1290 [13•9%]). Most respondents (6921 [82•0%] of 8441) continued their antirheumatic medications as prescribed. Almost all (9266 [99•7%] of 9297) respondents adopted protective behaviours to limit SARS-CoV-2 exposure. A change in employment status occurred in 2524 (27•1%) of 9300) of respondents, with a 13•6% decrease in the number in full-time employment (from 4066 to 3514).Interpretation People with rheumatic disease maintained therapy and followed public health advice to mitigate the risks of COVID-19. Substantial employment status changes occurred, with potential implications for health-care access, medication affordability, mental health, and rheumatic disease activity.Funding American College of Rheumatology.

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Section: Discussionmentioning

confidence: 73%

Immediate effect of the COVID-19 pandemic on patient health, health-care use, and behaviours: results from an international survey of people with rheumatic diseases

Kennedy

Moni

Levine

et al. 2021

The Lancet Rheumatology

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“…222 Therefore, assessing the impact of SDH on severity and mortality related to COVID-19 in patients with rheumatic diseases is essential. [223][224][225][226] Although telemedicine has played a significant role in securing continuity of care for patients with SLE and other rheumatic diseases during the pandemicrelated lockdowns 194,227,228 , concerns have been raised about specific situations where a virtual consultation may be insufficient. 229 For instance, patients with SLE require routine monitoring of laboratory parameters.…”

Section: Ancestral Background Socioeconomic Factors and Indirect Conmentioning

confidence: 99%

COVID-19 in patients with systemic lupus erythematosus: lessons learned from the inflammatory disease

Fernández-Ruiz

Paredes

Niewold

2021

Translational Research

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As the world navigates the Coronavirus disease 2019 (COVID-19) pandemic, there is a growing need to assess its impact in patients with autoimmune rheumatic diseases, such as systemic lupus erythematosus (SLE). Patients with SLE are a unique population when considering the risk of contracting COVID-19 and infection outcomes. The use of systemic glucocorticoids and immunosuppressants, and underlying organ damage from SLE are potential susceptibility factors. Most patients with SLE have evidence of high type I IFN activity, which may theoretically act as an antiviral line of defense or contribute to the development of a deleterious hyperinflammatory response in COVID-19. Other immunopathogenic mechanisms of SLE may overlap with those described in COVID-19, and thus studies in SLE could provide some insight into immune responses occurring in severe cases of the viral infection. We reviewed the literature to date on COVID-19 in patients with SLE and provide an in-depth review of current research in the area, including immune pathway activation, epidemiology, clinical features, outcomes, and the psychosocial impact of the pandemic in those with autoimmune disease.

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“…COVID-19 has also highlighted existing inequities in access to care for those who have been marginalised and members of minority groups; this is an issue that health systems must tackle in order to provide outstanding clinical care to the entirety of the population they serve. 5 The complexities of rapidly expanding existing capacity are illustrated by Griffin and colleagues, who report their preparations for an influx of critically ill patients at New York Presbyterian Hospital. 31 on May 30, 2021 by guest.…”

Section: Skillful Negotiation Of the Healthcare Systemmentioning

confidence: 99%

“…1 Black and minority ethnic communities have been disproportionately affected, due in large part to systemic inequities and structural barriers that limit access to healthcare as well as the higher proportion of members of these groups working in frontline industries where working from home is not possible. [3][4][5] Many healthcare institutions have struggled with the volume of patients who are presenting with COVID-19; the demand for staffing, personal protective equipment (PPE), testing, treatment and beds have largely exceeded supplies and capacity. With the sudden and overwhelming pressure to care for affected patients, attention was rightfully focused on expanding capacity and ensuring that systems were able to attend to those who needed to be served.…”

Section: Introductionmentioning

confidence: 99%

Review of the published literature to characterise clinical excellence in COVID-19 care

Garibaldi

Chisolm

Berkenblit

et al. 2021

Postgraduate Medical Journal

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COVID-19 continues to be a major source of global morbidity and mortality. It abruptly stressed healthcare systems early in 2020 and the pressures continue. Devastating hardships have been endured by individuals, families and communities; the losses will be felt for years to come. As healthcare professionals and organisations stepped up to respond to the overwhelming number of cases, it is understandable that the focus has been primarily on coping with the quantity of the demand. During a pandemic, it is not surprising that few papers have drawn attention to the quality of the care delivered to those afflicted with illness. Despite the challenges, clinicians caring for patients with COVID-19 have risen to the occasion. This manuscript highlights aspirational examples from the published literature of thoughtful and superb care of patients with COVID-19 using an established framework for clinical excellence (formulated by the Miller-Coulson Academy of Clinical Excellence).

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Removing barriers and disparities in health: lessons from the COVID-19 pandemic

Cited by 8 publications

References 9 publications

Immediate effect of the COVID-19 pandemic on patient health, health-care use, and behaviours: results from an international survey of people with rheumatic diseases

Immediate effect of the COVID-19 pandemic on patient health, health-care use, and behaviours: results from an international survey of people with rheumatic diseases

COVID-19 in patients with systemic lupus erythematosus: lessons learned from the inflammatory disease

Review of the published literature to characterise clinical excellence in COVID-19 care

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