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Concerns, Healthcare Use, and Treatment Interruptions in Patients With Common Autoimmune Rheumatic Diseases During the COVID-19 Pandemic.
George, Michael D; Venkatachalam, Shilpa; Banerjee, Shubhasree; Baker, Joshua F; Merkel, Peter A; Gavigan, Kelly; Curtis, David; Danila, Maria I; Curtis, Jeffrey R; Nowell, W Benjamin.
  • George MD; M.D. George, MD, MSCE, Assistant Professor, S. Banerjee, MD, Assistant Professor, J.F. Baker, MD, MSCE, Assistant Professor, P.A. Merkel, MD, MPH, Professor, University of Pennsylvania, Philadelphia, Pennsylvania; michael.george@pennmedicine.upenn.edu.
  • Venkatachalam S; S. Venkatachalam, PhD, MPH, K. Gavigan, MPH, D. Curtis, BA, W.B. Nowell, PhD, MSW, Global Healthy Living Foundation, Upper Nyack, New York.
  • Banerjee S; M.D. George, MD, MSCE, Assistant Professor, S. Banerjee, MD, Assistant Professor, J.F. Baker, MD, MSCE, Assistant Professor, P.A. Merkel, MD, MPH, Professor, University of Pennsylvania, Philadelphia, Pennsylvania.
  • Baker JF; M.D. George, MD, MSCE, Assistant Professor, S. Banerjee, MD, Assistant Professor, J.F. Baker, MD, MSCE, Assistant Professor, P.A. Merkel, MD, MPH, Professor, University of Pennsylvania, Philadelphia, Pennsylvania.
  • Merkel PA; M.D. George, MD, MSCE, Assistant Professor, S. Banerjee, MD, Assistant Professor, J.F. Baker, MD, MSCE, Assistant Professor, P.A. Merkel, MD, MPH, Professor, University of Pennsylvania, Philadelphia, Pennsylvania.
  • Gavigan K; S. Venkatachalam, PhD, MPH, K. Gavigan, MPH, D. Curtis, BA, W.B. Nowell, PhD, MSW, Global Healthy Living Foundation, Upper Nyack, New York.
  • Curtis D; S. Venkatachalam, PhD, MPH, K. Gavigan, MPH, D. Curtis, BA, W.B. Nowell, PhD, MSW, Global Healthy Living Foundation, Upper Nyack, New York.
  • Danila MI; M.I. Danila, MD, MSc, MSPH, Associate Professor, J.R. Curtis, MD, MS, MPH, Professor, University of Alabama at Birmingham, Birmingham, Alabama, USA.
  • Curtis JR; M.I. Danila, MD, MSc, MSPH, Associate Professor, J.R. Curtis, MD, MS, MPH, Professor, University of Alabama at Birmingham, Birmingham, Alabama, USA.
  • Nowell WB; S. Venkatachalam, PhD, MPH, K. Gavigan, MPH, D. Curtis, BA, W.B. Nowell, PhD, MSW, Global Healthy Living Foundation, Upper Nyack, New York.
J Rheumatol ; 48(4): 603-607, 2021 04.
Article in English | MEDLINE | ID: covidwho-945989
ABSTRACT

OBJECTIVE:

To assess concerns and healthcare-related behaviors of patients with autoimmune rheumatic diseases during the coronavirus disease 2019 (COVID-19) pandemic.

METHODS:

Adults from the United States with rheumatoid arthritis (RA), psoriatic arthritis (PsA), ankylosing spondylitis (AS), and systemic lupus erythematosus (SLE) from the ArthritisPower Patient-Powered Research Network and CreakyJoints patient community completed surveys. Concerns and behaviors were compared among patients with different autoimmune conditions, disease-modifying antirheumatic drug (DMARD) use, and geographic measures of urban status, income, education, and COVID-19 activity.

RESULTS:

Among 1517 participants (925 RA, 299 PsA, 185 AS, 108 SLE), mean age was 55.1 years, 88.3% were female, and 89.5% were White. COVID-19 concerns were similar across the country and were higher in biologic users (P < 0.001). Avoidance of doctor's office visits (56.6%) or laboratory testing (42.3%) and use of telehealth (29.5%) were more common in urban areas. Among participants receiving a DMARD without COVID-19 or other respiratory illness, 14.9% stopped a DMARD, with 78.7% of DMARD interruptions not recommended by a physician. DMARD stopping was more common in participants with lower socioeconomic status (SES) and in participants who avoided an office visit (OR 1.46, 95% CI 1.04-2.04) or reported lack of telehealth availability OR 2.26 (95% CI 1.25-4.08).

CONCLUSION:

In the early months of the COVID-19 pandemic, patients with RA, PsA, AS, and SLE frequently avoided office visits and laboratory testing. DMARD interruptions commonly occurred without the advice of a physician and were associated with SES, office visits, and telehealth availability, highlighting the need for adequate healthcare access and attention to vulnerable populations during the pandemic.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Rheumatic Diseases / Antirheumatic Agents / COVID-19 Type of study: Observational study / Prognostic study Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: J Rheumatol Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Rheumatic Diseases / Antirheumatic Agents / COVID-19 Type of study: Observational study / Prognostic study Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: J Rheumatol Year: 2021 Document Type: Article