Impact of lockdown on rheumatology outpatient care in the age of COVID-19

Singh, Benjamin; Chuah, Seow Lin; Cheong, Yaw Kiet; Wan, Sharifah Aishah; Teh, Cheng Lay

doi:10.1136/annrheumdis-2020-218484

Cited by 5 publications

(5 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The study confirmed the findings of the WHO in a substantial number of Mexican outpatients with chronic rheumatic diseases. We found that one in two patients experienced HCI, in line with results of previous reports from the United States [ 19 , 25 ] and Europe [ 3 , 26 ], although higher percentages had been described among surveyed patients attending rheumatology services in 35 European countries [ 27 ], and attending a general rheumatology clinic at designated COVID-19 hybrid hospital in Malaysia [ 28 ]. The reasons for medical care interruption highlight a combination of institutional decisions to temporally close outpatient clinics and patients’ own decisions to avoid hospital visits [ 19 , 25 , 27 , 28 ].…”

Section: Discussionsupporting

confidence: 91%

“…(Long) disease duration, substantial disease activity level previous HCI, need for rheumatic care, and NP with (rheumatic disease-related) treatment were associated with clinical deterioration. Hassen et al [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] surveyed 3000 rheumatic patients during the current pandemic in Saudi Arabia, with the aim to capture patients' experiences. Among the 637 respondents, patient perception of worsened disease activity was correlated to unplanned healthcare visits (which might be considered a surrogate for the need for rheumatic medical care), medication non-adherence (a surrogate for NP with treatment), and difficulty in accessing medication, which was in fact the main reason for treatment discontinuation among our patients.…”

Section: Plos Onementioning

confidence: 99%

“…The authors reported that up to 41% of the patients referred difficulty in obtaining hydroxychloroquine and 40.7% of the patients referred disease flare. Non-adherence to treatment has been extensively described in patients with rheumatic diseases during the COVID-19 pandemic and has been attributed to limited access to medications as well as to patients' fears related to immunosuppressive drugs [3,13,19,25,26,28,[30][31][32].…”

Section: Plos Onementioning

confidence: 99%

See 2 more Smart Citations

Clinical and bioethical implications of health care interruption during the COVID-19 pandemic: A cross-sectional study in outpatients with rheumatic diseases

et al. 2021

View full text Add to dashboard Cite

Background To determine the impact of health care interruption (HCI), on clinical status of the patients reincorporated to an outpatient clinic for rheumatic diseases (OCDIR), from a tertiary care level center who was temporally switched to a dedicated COVID-19 hospital, and to provide a bioethical analysis. Methods From March to June 2020, the OCDIR was closed; since June, it is limited to evaluate 25% of the ongoing outpatients. This cross-sectional study surveyed 670 consecutive rheumatic outpatients between June 24th and October 31th, concomitant to the assessment of the rheumatic disease clinical status by the attendant rheumatologist, according to disease activity level, clinical deterioration and adequate/inadequate control. Multiple logistic regression analysis identified factors associated to HCI and to clinical deterioration. Results Patients were middle-aged females (86.7%), with median disease duration of 10 years, comorbidity (38.5%) and 138 patients (20.6%) had discontinued treatment. Primary diagnoses were SLE and RA, in 285 (42.5%) and 223 (33.3%) patients, respectively. There were 344 patients (51.3%) with HCI. Non-RA diagnosis (OR: 2.21, 95%CI: 1.5–3.13), comorbidity (OR: 1.7, 95%CI: 1.22–2.37), patient’s need for rheumatic care during HCI (OR: 3.2, 95%CI: 2.06–4.97) and adequate control of the rheumatic disease (OR: 0.64, 95%CI: 0.45–0.9) were independently associated to HCI. There were 160 patients (23.8%) with clinical deterioration and associated factors were disease duration, substantial disease activity previous HCI, patients need for rheumatic care and treatment discontinuation. Conclusions HCI during COVID-19 pandemic impacted course of rheumatic diseases and need to be considered in the bioethical analysis of virus containment measures.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Plos Onementioning

confidence: 99%

Section: Plos Onementioning

confidence: 99%

See 1 more Smart Citation

Clinical and bioethical implications of health care interruption during the COVID-19 pandemic: A cross-sectional study in outpatients with rheumatic diseases

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Data from the United States show a 60% decline in in-person outpatient visits from mid-February to late March 2020. 15 In Malaysia, Singh et al 16 demonstrated a reduction of 70.9% in general rheumatology clinics and 58.9% in SLE clinics. In a rheumatology center in Mexico, 51.3% of patients did not receive any kind of specialty care at the beginning of the pandemic.…”

Section: Discussionmentioning

confidence: 98%

How Did Patients Living With Immune-Mediated Rheumatic Diseases Face the Beginning of the COVID-19 Pandemic in Brazil? Results of the COnVIDa Study

et al. 2022

View full text Add to dashboard Cite

Background:The coronavirus disease 2019 (COVID-19) pandemic has brought additional burden to patients living with immune-mediated rheumatic diseases (IMRDs), especially at the beginning of 2020, for which information for this population is lacking.Methods: COnVIDa is a cross-sectional study on patients with IMRD from all regions of Brazil who were invited to answer a specific and customized Web questionnaire about how they were facing the COVID-19 pandemic, especially focusing on health care access, use of medications, and patient-reported outcomes related to IMRD activity. The questionnaire was applied from June 1 to 30, 2020. Results:In total, 1722 of 2576 patients who answered the Web questionnaire were included in the final analysis. Participants were most frequently women, 56% were between 31 and 50 years old, and most (55%) has private health insurance. The most commonly reported IMRD was rheumatoid arthritis (39%), followed by systemic lupus erythematosus (28%). During the study period, 30.7% did not have access to rheumatology consultations, and 17.6% stopped chronic medications. Telemedicine was reported in 44.8% of patients. Conclusion:COnVIDa demonstrated a negative impact on health care access and treatment maintenance of patients living with IMRD during the COVID-19 pandemic. However, it also presented an uptake of telemedicine strategies. Data presented in this study may assist future coping policies.

show abstract

“…[8][9][10][11] The new Coronavirus Disease 2019 (COVID-19) unprecedentedly evolved and challenged health care systems with a specific impact on patients with long-term conditions. 12 Rheumatoid arthritis patients were affected by the partial or total closure of outpatient clinics that was applied during the pandemic and negatively affected disease management 13 and aggravated the RA-related psychological burden, paralleled with the pandemic-associated psychological impact due to social distancing and the fear of contracting the disease. 14 In addition, the governmental authorities and the Centers for Disease Control and Prevention (CDC) have also highlighted that COVID-19 implies a threat to patients with long-term and autoimmune disorders.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Depression and Anxiety in Rheumatoid Arthritis Patients During COVID-19 Pandemic

Abd EL-Khalik,

Eltohamy

2023

Clin Med�Insights�Arthritis�Musculoskelet Disord

View full text Add to dashboard Cite

Background: Rheumatoid arthritis (RA) disease activity, associated comorbidities, and therapy-related side effects impair the physical, social, and emotional dimensions of the patient’s health. Presently, the ongoing COVID-19 pandemic has been associated with a broad range of psychosocial disorders in various populations. Patients with RA are especially vulnerable to such effects. Objectives: Detect the prevalence of recent COVID-19 infection among patients with RA, assess depression and anxiety in these patients and their associated factors during the COVID-19 pandemic and their potential relation to disease activity. Design and Methods: This is a cross-sectional study conducted on 120 adult Egyptian patients diagnosed with RA during the COVID-19 pandemic. The prevalence of recent COVID-19 infection among the patients was evaluated. The patients underwent psychological assessment using the Hamilton Depression Rating Scale (Ham-D) and the Hamilton Anxiety Rating Scale (Ham-A) to measure levels of depression and anxiety levels. The RA disease activity was assessed using Disease Activity Score (DAS) Das-28-ESR. Results: This study encompasses a total of 120 RA patients. The prevalence of patients with a recent history of COVID-19 infection was 40.8%. Both groups exhibited significantly elevated mean scores on the Das-28-ESR scale and also scored higher on measures of depression and anxiety. Interestingly, the COVID-19 group exhibited a higher percentage of unmarried individuals, had educational attainment below the university level, and were unemployed. Patients with recent COVID-19 had significantly lower numbers of children, higher disease duration, higher Das-28-ESR scores, and elevated depression and anxiety scores. The statistical analysis revealed that the COVID-19 infection and disease duration were significant predictors of depression and anxiety. The results also exhibited that the depression score was positively correlated with age and DAS scores. Conclusions: It was observed that patients diagnosed with RA revealed a higher prevalence of COVID-19 infection. The occurrence of depression and anxiety was observed to be widespread among patients diagnosed with RA and, more significantly, prevalent in RA patients who had a recent COVID-19 and had a higher level of disease activity. The occurrence of COVID-19 and disease duration were identified as factors that can anticipate the development of depression and anxiety.

show abstract

Impact of lockdown on rheumatology outpatient care in the age of COVID-19

Cited by 5 publications

References 7 publications

Clinical and bioethical implications of health care interruption during the COVID-19 pandemic: A cross-sectional study in outpatients with rheumatic diseases

Clinical and bioethical implications of health care interruption during the COVID-19 pandemic: A cross-sectional study in outpatients with rheumatic diseases

How Did Patients Living With Immune-Mediated Rheumatic Diseases Face the Beginning of the COVID-19 Pandemic in Brazil? Results of the COnVIDa Study

Evaluation of Depression and Anxiety in Rheumatoid Arthritis Patients During COVID-19 Pandemic

Contact Info

Product

Resources

About