Treatment adherence during the COVID-19 pandemic and the impact of confinement on disease activity and emotional status: A survey in 644 rheumatic patients

López-Medina, Clementina; Ladehesa-Pineda, Lourdes; Gómez-García, Ignacio; Puche-Larrubia, María Ángeles; Sequí-Sabater, José Miguel; Armenteros-Ortiz, Pedro; Ortega‐Castro, Rafaela; Garrido-Castro, Juan Luis; Contreras, A. Escudero; Collantes-Estévez, Eduardo

doi:10.1016/j.jbspin.2020.105085

Cited by 29 publications

(35 citation statements)

References 5 publications

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“…We found that 10% of patients receiving immunomodulatory medications had stopped one of their medications because of concerns about COVID‐19, even if they were well with no COVID‐19 diagnosis or respiratory illness. Most medication interruptions were not recommended by a physician, similar to results from previous studies (10–12,22,23). Guidance from the American College of Rheumatology recommends not stopping medications unless patients have contracted or been exposed to severe acute respiratory syndrome coronavirus 2, although this guidance was first published in April 2020 and was not available when many patients answered their surveys (24).…”

Section: Discussionsupporting

confidence: 85%

Social Distancing, Health Care Disruptions, Telemedicine Use, and Treatment Interruption During the COVID‐19 Pandemic in Patients With or Without Autoimmune Rheumatic Disease

George

Baker

Banerjee

et al. 2021

ACR Open Rheumatology

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Background We aimed to compare concerns, social distancing, health care disruptions, and telemedicine use in patients with autoimmune rheumatic disease (ARD) and non‐ARD and to evaluate factors associated with immunomodulatory medication interruptions. Methods Patients in a multistate community rheumatology practice network completed surveys from April 2020 to May 2020. Adults with common ARD (rheumatoid arthritis, spondyloarthritis, systemic lupus erythematosus) or non‐ARD (gout, osteoarthritis, osteoporosis) were evaluated. Concerns about coronavirus disease 2019 (COVID‐19), social distancing, health care disruptions, and telemedicine use were compared in patients with ARD versus non‐ARD, adjusting for demographics, rural residence, and zipcode‐based measures of socioeconomic status and COVID‐19 activity. Factors associated with medication interruptions were assessed in patients with ARD. Results Surveys were completed by 2319/36 193 (6.4%) patients with non‐ARD and 6885/64 303 (10.7%) with ARD. Concerns about COVID‐19 and social distancing behaviors were similar in both groups, although patients receiving a biologic or Janus kinase (JAK) inhibitor reported greater concerns and were more likely to avoid friends/family, stores, or leaving the house. Patients with ARD were less likely to avoid office visits (45.2% vs. 51.0%, odds ratio [OR] 0.79 [0.70‐0.89]) with similar telemedicine use. Immunomodulatory medications were stopped in 9.7% of patients with ARD, usually (86.9%) without a physician recommendation. Compared with patients with an office visit, the likelihood of stopping medication was higher for patients with a telemedicine visit (OR 1.54 [1.19‐1.99]) but highest for patients with no visits (OR 2.26 [1.79‐2.86]). Conclusion Patients with ARD and non‐ARD reported similar concerns about COVID‐19 and similar social distancing behaviors. Missed office visits were strongly associated with interruptions in immunomodulatory medication.

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Section: Discussionsupporting

confidence: 85%

Social Distancing, Health Care Disruptions, Telemedicine Use, and Treatment Interruption During the COVID‐19 Pandemic in Patients With or Without Autoimmune Rheumatic Disease

George

Baker

Banerjee

et al. 2021

ACR Open Rheumatology

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“…Whether the follow-up, treatment, and disease activity of rheumatological diseases changed during the pandemic has been the subject of many studies [46,47]. Lopez et al…”

Section: Discussionmentioning

confidence: 99%

“…investigated whether the disease activity scores of patients with RA and axial spondyloarthritis changed during the pandemic period and observed that 37.4% of the patients showed worsening of disease activity. [46]. On the other hand, Ciurea et al found that disease activity of patients with neither RA nor AS increased significantly during the COVID-19 pandemic [47].…”

Section: Discussionmentioning

confidence: 99%

Effects of the COVID-19 pandemic on psychology and disease activity in patients with ankylosing spondylitis and rheumatoid arthritis

Gıca¹,

Akkubak²,

Aksoy³

et al. 2021

Turk J Med Sci

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Background/aim: The COVID-19 outbreak is known to increase stress levels of most patients with chronic diseases. Patients with Ankylosing Spondylitis (AS) and Rheumatoid Arthritis (RA) are highly susceptible to environmental stress. In the current study, we aimed to determine how the COVID-19 pandemic psychologically affected patients with chronic progressive diseases such as AS and RA and the effects of these psychological factors on disease activity.Materials and methods: Age and gender-matched patients with AS (n=80), RA (n=80), and healthy controls (n=80) were included in the study. All participants were evaluated with the "Perceived COVID-19 Threat Form (PCTF)", "Suicide-Ideation Scale (SIS)", "Hospital Anxiety and Depression Scale (HADS)", "The Ability to Cope with Trauma (PACT)" and "Psychological General Well-Being Index (PGWB)" scales. BASDAI was used in patients with AS and DAS28 was used in patients with RA to assess disease severity.Results: Compared to healthy individuals, patients with RA and AS had lower PGWB scores and higher HADS depression and anxiety subscale scores. Almost all psychometric assessment test scores were worse in AS patients with high-disease activity compared to those in low-disease activity. PACT scores were higher in patients with moderate RA compared to patients with mild RA (p=0.006). While a positive correlation was identified between BASDAI and most of the psychometric assessment test scores (r=0 .36 for PCTF, r= 0.53 for depressive scores, r= 0.54 for anxiety scores, r= 0.57 for suicidal 2 ideation), DAS28 scores were found to be associated only with PACT total and PACT perceived forward-focused subscale scores (r= -.26 and r= .33, respectively). Conclusion:Psychologically, AS and RA patients were found to be worse off compared to healthy controls. The perceived COVID threat and psychological status were associated with disease activity in AS, but not RA patients. Patients with chronic illnesses may be more vulnerable to the psychological effects of the pandemic, which can worsen disease activity.

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“…Not only were our healthcare systems almost at full capacity (emergency departments and hospitalizations) and with reduced or even at times suspended outpatient care, but also citizens were subjected to sometimes stringent limitations of movement (including home confinement). 29 As an example, if we consider autoinflammatory syndromes, flares can be associated with very severe and life-threatening manifestations. In addition, typically they are associated with fever, one of the more common symptoms of COVID-19.…”

Section: Discussionmentioning

confidence: 99%

Influence of colchicine prescription in COVID-19-related hospital admissions: a survival analysis

Madrid

Pérez

Colomer

et al. 2021

Therapeutic Advances in Musculoskeletal

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Aims: To analyze the association between colchicine prescription and COVID-19-related hospital admissions in patients with rheumatic and musculoskeletal diseases (RMDs). Methods: Patients attending a rheumatology outpatient clinic from a tertiary care center in Madrid, Spain, from 1 September 2019 to 29 February 2020 were included. Patients were assigned as exposed or unexposed based on whether they were prescribed with colchicine in their last visit to the clinic during the 6 months before the start of the observation period. Treatment changes during the observation period were also considered. The primary outcome was COVID-19-related hospital admissions between 1 March and 20 May 2020. Secondary outcome included COVID-19-related mortality. Several weighting techniques for data balancing, based and non-based on the propensity score, followed by Cox regressions were performed to estimate the association of colchicine prescription on both outcomes. Discussion: The number of patients entered in the study was 9379, with 406 and 9002 exposed and unexposed follow-up periods, respectively. Generalized Boosted Models (GBMs) and Empirical Balancing Calibration Weighting (EBCW) methods showed the best balance for COVID-19-related hospital admissions. Colchicine prescription did not show a statistically significant association after covariable balancing ( p-value = 0.195 and 0.059 for GBM and EBCW, respectively). Regarding mortality, the low number of events prevented a success variable balancing and analysis. Conclusion: Colchicine prescription does not play a significant protective or risk role in RMD patients regarding COVID-19-related hospital admissions. Our observations could support the maintenance of colchicine prescription in those patients already being treated, as it is not associated with a worse prognosis. Plain language title: Colchicine influence in COVID-19-related hospital admissions

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Treatment adherence during the COVID-19 pandemic and the impact of confinement on disease activity and emotional status: A survey in 644 rheumatic patients

Cited by 29 publications

References 5 publications

Social Distancing, Health Care Disruptions, Telemedicine Use, and Treatment Interruption During the COVID‐19 Pandemic in Patients With or Without Autoimmune Rheumatic Disease

Social Distancing, Health Care Disruptions, Telemedicine Use, and Treatment Interruption During the COVID‐19 Pandemic in Patients With or Without Autoimmune Rheumatic Disease

Effects of the COVID-19 pandemic on psychology and disease activity in patients with ankylosing spondylitis and rheumatoid arthritis

Influence of colchicine prescription in COVID-19-related hospital admissions: a survival analysis

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