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

Glintborg, Bente; Jensen, Dorte Vendelbo; Engel, Sara; Terslev, Lene; Pfeiffer-Jensen, Mogens; Hendricks, Oliver; Østergaard, Mikkel; Rasmussen, Simon; Adelsten, Thomas; Colic, Ada; Danebod, Kamilla; Kildemand, Malene; Loft, Anne Gitte; Munk, Heidi Lausten; Pedersen, J. Boiden; Østgård, René; Sørensen, Christian Møller; Krogh, Niels Steen; Agerbo, Jette Nørgaard; Ziegler, Connie; Hetland, Merete Lund

doi:10.1136/rmdopen-2020-001505

Cited by 55 publications

(79 citation statements)

References 23 publications

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“…So far, few studies have assessed the impact of the COVID-19 pandemic on medication adherence in patients with rheumatic and respiratory diseases. In these studies, adherence was measured with self-report and results were conflicting, with some studies reporting a negative effect, and some reporting no effect [33][34][35][36][37]. One study analysed controller inhaler use in asthma and chronic obstructive pulmonary disease patients whose devices were electronically tracked and who received an alert for missed doses [38].…”

Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 lockdown on the adherence of stroke patients to direct oral anticoagulants: a secondary analysis from the MAAESTRO study

et al. 2021

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Background The negative impact of the COVID-19 outbreak on stroke care has been reported, but no data exist on the influence of the lockdown on medication adherence to antithrombotic treatment for stroke prevention. We present a comparison of electronic adherence data of stroke patients treated with direct oral anticoagulants (DOAC) prior to and during the COVID-19 lockdown in spring 2020 in Switzerland. Methods This is a secondary analysis using data from the ongoing MAAESTRO study, in which stroke patients with atrial fibrillation electronically monitor their adherence to DOAC treatment. Eligible patients for this analysis had at least four weeks of adherence data prior to and during the COVID-19 lockdown. Three adherence metrics (taking adherence, timing adherence, drug holidays) were calculated and compared descriptively. Results The analysis included eight patients (median age 81.5 years, IQR 74.8–84.5). Five patients had a pre-lockdown taking adherence over 90% (mean 96.8% ± 2.9), with no change during lockdown, high timing adherence in both periods and no drug holidays. The remaining three patients had pre-lockdown taking and timing adherence below 90%. Of those, two patients showed a moderate decline either in taking or timing adherence compared to pre-lockdown. One showed a substantial increase in taking and timing adherence during lockdown (both + 25.8%). Conclusion Our data suggest that a major disruption of social life (i.e., the imposed COVID-19 lockdown) is unlikely to relevantly affect the medication intake behaviour of patients with high pre-established adherence, but might have an impact in patients with previously suboptimal adherence. Trial registration number MAAESTRO: electronic Monitoring and improvement of Adherence to direct oral Anticoagulant treatment—a randomized crossover study of an Educational and reminder-based intervention in ischaemic STROke patients under polypharmacy, NCT03344146.

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Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 lockdown on the adherence of stroke patients to direct oral anticoagulants: a secondary analysis from the MAAESTRO study

et al. 2021

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“…For example, a recent study of individuals included in the inflammatory rheumatoid disease registry had a participation rate of 35%. 14 Another study about seeking health care outside of regular clinical hours reported a participation rate of 36% for the random sample. 15 When examining their response rate by age groups, the response rate for individuals aged 50 to 59 years was the same as ours (44%), whereas, for individuals aged 30 to 39 years, it was lower than ours (23% versus 40%).…”

Section: Discussionmentioning

confidence: 99%

The Danish Diabetes Musculoskeletal Cohort: Non-Responder Analysis of an Electronic Survey Using Registry Data

Boyle¹,

Folkestad²,

Frafjord³

et al. 2021

CLEP

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Purpose To conduct a non-responder analysis on a musculoskeletal (MSK) electronic questionnaire. Methods Individuals aged 18 years and older, diagnosed with diabetes mellitus (DM), and attended an ambulatory DM clinic formed the sample frame. They were invited to complete an electronic musculoskeletal (MSK) conditions and symptoms questionnaire booklet using a secured electronic email system. Individuals whose secured email box was not active at the time were discarded. Using the Central Person Registry number, a unique number assigned to all Danish residents, we linked the sample frame to different registries to learn more about non-responders. Non-responders were either individuals who did not respond to a single question and those who responded “No” to the first question about willing to participate. We calculated descriptive statistics for each characteristic. Univariate logistic regression models were conducted to determine the relationship between each characteristic and non-responder status. Results The response rate was 36% (n = 3812). Individuals with type 2 DM (OR 2.0 (95% CI 1.8–2.2)), secondary DM (1.9 (1.3–2.8)) or unspecified DM (2.1 (1.8–2.4)) were more likely to be non-responders than individuals with Type 1 DM. Also, individuals aged 70–79 (1.3 (1.1–1.6)) and 80 years and older (5.9 (4.5–7.7)) were more likely to be non-responders than 18–29 years old individuals. However, individuals aged 40–49 (1.5 (1.2–1.8)), 50–59 (1.5 (1.3–1.8)) or 60–69 (1.4 (1.1–1.6)) were more likely to be responders than 18–29 years old individuals. Individuals with Charlson Comorbidity Index (CCI) of 1 (2.0 (1.3.2.9) or CCI of 2 (1.7 (1.1–2.5) were more likely to be responders than individuals with a CCI of 0. Lastly, individuals who were currently outside of the workforce (1.6 (2.4–2.9) or had unknown/missing socioeconomic status (3.9 (2.8–5.3) were more likely to be non-responders than individuals who were working. Conclusion Although we did find a non-response bias, this cohort will be an important source to determine the prevalence and consequences of MSK conditions in a secondary care DM population.

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“…Indeed, the authors of that global survey also found that changes in healthcare services for health issues other than COVID-19 had moderate or severe effects on patients since the COVID-19 outbreak (Chudasama et al, 2020). Worry about contracting COVID-19 was high amongst people with arthritis, with a higher proportion of self-isolation amongst people who have arthritis due to their condition compared to others their age (Glintborg et al, 2021). In our experience, some of the MEDRA and PIPPRA participants' hesitancy and COVID-19 fear around engaging in clinical research was influenced by family members, including adult children.…”

Section: Summary Of Main Findingsmentioning

confidence: 99%

The impact of COVID-19 on clinical research: the PIPPRA and MEDRA experience

et al. 2021

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Background: Coronavirus disease 2019 (COVID-19) has had a significant impact on clinical research. This paper aims to provide an insight into how the COVID-19 pandemic, associated public health restrictions and international guidance on the conduct of clinical research impacted two clinical rheumatology research trials - the Physiotherapist-led Intervention to Promote Physical Activity in Rheumatoid Arthritis (PIPPRA) and the MEDiterranean diet in Rheumatoid Arthritis (MEDRA) projects. Methods: The March 2019 public health restrictions imposed to mitigate the risk of COVID-19 occurred at a time when PIPPRA was in the process of delivering assessment and intervention on a face-to-face basis (n=48) and MEDRA had commenced recruitment. Participants in PIPPRA and MEDRA had a diagnosis of rheumatoid arthritis, with some being immunosuppressed and thus at a higher risk for COVID-19. The decision-making processes of both trials is outlined to demonstrate the required amendments to continue in the context of the COVID-19 pandemic. Results: Amendments to PIPPRA and MEDRA trial protocols were agreed and received ethical and funder approval. Both trials switched from a face-to-face delivery to a telehealth using online platforms. The PIPPRA study was paused for five months (April-August 2020), resulting in n=33 (60%) deviations from assessment protocol. MEDRA switched from face-to-face to online recruitment with 20% (n=35/44) deviation in recruitment. Of the n=18 participants who consented to participating in a face-to-face trial, just n=2 (11%) opted to engage with telehealth delivery of the intervention. MEDRA assessment and intervention deviations were 100% as no sessions were completed as planned in 2020. Conclusions: The COVID-19 pandemic has severely impacted the PIPPRA and MEDRA clinical trials. Moving face-to-face clinical research to telehealth delivery may not be the panacea it is purported to be. Our experiences may be of benefit to researchers, clinicians, and funders in seeking to continue clinical research during a global pandemic.

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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

Cited by 55 publications

References 23 publications

Impact of the COVID-19 lockdown on the adherence of stroke patients to direct oral anticoagulants: a secondary analysis from the MAAESTRO study

Impact of the COVID-19 lockdown on the adherence of stroke patients to direct oral anticoagulants: a secondary analysis from the MAAESTRO study

The Danish Diabetes Musculoskeletal Cohort: Non-Responder Analysis of an Electronic Survey Using Registry Data

The impact of COVID-19 on clinical research: the PIPPRA and MEDRA experience

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