Response to: ‘Telerheumatology in COVID-19 era: a study from a psoriatic arthritis cohort’ by Costa <i>et al</i>

Gupta, Latika; Misra, Durga Prasanna; Agarwal, Vishwesh; Balan, Suma; Agarwal, Vikas

doi:10.1136/annrheumdis-2020-217953

Cited by 18 publications

(17 citation statements)

References 6 publications

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“…The strategy to switch to tele-rheumatology would also benefit the patients and their families financially as the OOPE can be minimized. Such models can ensure optimum decentralized health-care delivery for majority of patients with chronic diseases and help decongest tertiary care centres [ 24 ], thus also maintaining the norms of physical distancing [ 25 ]. We found that the families with a lower monthly family income [median of INR 6000 (US$ 78)] are likely to default and attempts like tele-rheumatology can result in cutting down on the direct non-medical and indirect healthcare-related cost and job absenteeism.…”

Section: Discussionmentioning

confidence: 99%

Tele-rheumatology for overcoming socioeconomic barriers to healthcare in resource constrained settings: lessons from COVID-19 pandemic

Kavadichanda¹,

Shah²,

Daber³

et al. 2020

Rheumatology

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Objectives To assess acceptability of teleconsultation among the socioeconomically marginalized sections of patients with rheumatic and musculoskeletal diseases (RMDs), to identify the socioeconomic barriers in continuing rheumatology care during the COVID-19 crisis and to identify patients who could benefit by shifting to tele-rheumatology consultations. Methods This was a cross sectional analytical study done at a tertiary care teaching hospital in India including patients with RMDs who were not on biological diseases modifying agents. Assessment of disease status, socioeconomic status and economic impact of COVID-19 was done via tele-consultation. Results Out of the 680 patients satisfying inclusion criteria, 373 completed the study. The format was found easy by 334 (89.6%) of them and 284 (76.1%) considered tele-rheumatology better than in-person consultation. During the pre-COVID months, the median monthly per capita income of the families of our patients and cost of illness was Indian rupees (INR) 2000 (US$ 26) and INR 1685 (US$ 21.91), respectively. Families whose financial needs were met (OR = 0.38, 95% CI: 0.239, 0.598) or those with schooling upto at least secondary school (OR = 0.442, 95% CI: 0.260, 0.752) ( P =0.002) were less likely to stop prescription drugs. In a hypothetical model, 289 (77.4%) could be successfully switched to tele-rheumatology follow-up. Conclusion The acceptability of tele-rheumatology among socioeconomically marginalized patients with RMDs is good. During times of crisis, patients from poorer strata of society and lower educational background are likely to abruptly stop medications. Switching to a telemedicine-based hybrid model is likely to improve drug adherence with substantial savings on loss of pay and out of pocket expenditure.

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Section: Discussionmentioning

confidence: 99%

Tele-rheumatology for overcoming socioeconomic barriers to healthcare in resource constrained settings: lessons from COVID-19 pandemic

Kavadichanda¹,

Shah²,

Daber³

et al. 2020

Rheumatology

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“…The concept of tele-triaging (triaging in teleconsultation) has to be practiced in e-consults and has been emphasised in other studies too [ 3 , 22 ]. NLC has outperformed physician-driven remote consultation in rheumatoid arthritis in Africa and Middle East countries in a few studies.…”

Section: Discussionmentioning

confidence: 99%

“…However, the situation in chronic RDs, such as IIM, may be met with additional challenges due to more frequently hampered mobility, distinctive need to measure muscle strength objectively, varied organ system involvement, and frequent need for admissions. [ 3 ] In a LMIC, the availability of smartphones and internet access in rural areas may be limited. Language diversity and poor literacy is another impediment to successful communication, and a major concern while delivering care remotely.…”

Section: Introductionmentioning

confidence: 99%

Teleconsultation experience with the idiopathic inflammatory myopathies: a prospective observational cohort study during the COVID-19 pandemic

et al. 2020

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Teleconsultation has assumed a central role in the management of chronic and disabling rheumatic diseases, such as the idiopathic inflammatory myopathies (IIM), during COVID-19. However, the feasibility, challenges encountered, and outcomes remain largely unexplored. Here, we describe our teleconsultation experience in a prospectively followed cohort of adult and juvenile IIM. 250 IIM enrolled into the MyoCite cohort (2017-ongoing) were offered the option of audio/visual teleconsultation using WhatsApp during the nationwide lockdown. Clinical outcomes (major/minor relapse) and prescription changes were compared between IIM subsets. Socio-demographic and clinico-serological characteristics of those who sought teleconsultation were compared with those who did not. 151 teleconsultations were sought over a 93 day period by 71 (52.2%) of 136 IIM (median age 38 years, F:M 4.5:1). Nearly one-third (38%) consulted on an emergency basis, with voice consultations being the primary medium of communication. Over a quarter (26.8%) reported relapse (15.5% minor, 11.3% major), these being more common in JDM [71.4%, OR 8.9 (1.5–51)] as compared with adult IIM, but similar across various antibody-based IIM subtypes. Patients who relapsed required more consultations [2(2–3) vs 1(1–2), p 0.009]. The demographic and socioeconomic profile of the patients seeking consultation ( n = 71) was not different from those who did not ( n = 65). Voice-based teleconsultations may be useful to diagnose and manage relapses in IIM during the pandemic. Patient education for meticulous and timely reporting may be improve care, and larger multicentre studies may identify subsets of IIM that require greater care and early tele-triage for effective management of the condition.

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“…Access to teleconsultations has been eased by widespread access to the Internet and newer apps, which has made certain procedures cheaper. 23 Electronic informed consent (EIC) has been tested as a possible method to consent while preserving the patient's integrity. Hussein et al, 2017 concluded that the use of smartphones enhanced enrollment of patients in time-sensitive clinical research such as DAWN (Acute Stroke Trial) as well as other interventions.…”

Section: Positive Changes On Informed Consent During Covid-19 Pandemimentioning

confidence: 99%

Informed Consent for Scholarly Articles during the COVID-19 Pandemic

Jones¹,

Zimba

Gupta

2021

J Korean Med Sci

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Response to: ‘Telerheumatology in COVID-19 era: a study from a psoriatic arthritis cohort’ by Costa et al

Cited by 18 publications

References 6 publications

Tele-rheumatology for overcoming socioeconomic barriers to healthcare in resource constrained settings: lessons from COVID-19 pandemic

Tele-rheumatology for overcoming socioeconomic barriers to healthcare in resource constrained settings: lessons from COVID-19 pandemic

Teleconsultation experience with the idiopathic inflammatory myopathies: a prospective observational cohort study during the COVID-19 pandemic

Informed Consent for Scholarly Articles during the COVID-19 Pandemic

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