Influence of COVID-19 pandemic on decisions for the management of people with inflammatory rheumatic and musculoskeletal diseases: a survey among EULAR countries
Influence of COVID-19 pandemic on decisions for the management of people with inflammatory rheumatic and musculoskeletal diseases: a survey among EULAR countries
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DOI：
10.1136/annrheumdis-2020-218697
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发表时间：
2021-04-01
影响因子：
27.4
通讯作者：
Buttgereit, Frank
中科院分区：
文献类型：
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作者：
Dejaco, Christian;Alunno, Alessia;Buttgereit, Frank
目的 调查第一波 COVID-19 大流行如何影响风湿病学家和风湿病卫生专业人员在治疗炎症性风湿病和肌肉骨骼疾病 (RMD) 患者方面的决策。方法 EULAR 工作组制定了英语调查问卷，并通过 EULAR 国家的国家风湿病学会、EMEUNET 和各个工作组成员分发。使用在线调查工具收集回复。计算了描述性统计数据。结果 我们分析了来自 35/45 EULAR 国家的 1286 份回复。由于遏制措施，82%的受访者表示取消/推迟新患者的面诊（其中84%提供远程会诊）和91%的随访（96%提供远程会诊）。大多数受访者（58%）认为，在遏制限制期间，症状出现和第一次风湿病咨询之间的间隔比以前更长。治疗决定经常被推迟（34%），大多数（74%）受访者表示，在大流行期间不太可能开始使用生物疾病修饰抗风湿药物（DMARD）/靶向合成 DMARD，主要是因为患者的恐惧、筛查程序的可用性有限以及风湿病服务的可用性减少。分别有 47% 和 42% 的受访者报告使用（羟基）氯喹 (HCQ) 和托珠单抗 (TCZ) 治疗 COVID-19 适应症，分别有 49% 和 14% 的受访者表示，这些药物用于 RMD 适应症短缺。 HCQ 和 TCZ，从而对早期治疗和目标治疗策略产生负面影响。
Objectives To investigate how the first wave of COVID-19 pandemic influenced decisions of rheumatologists and health professionals in rheumatology regarding the management of patients with inflammatory rheumatic and musculoskeletal diseases (RMDs).Methods An English-language questionnaire was developed by a EULAR working group and distributed via national rheumatology societies of EULAR countries, EMEUNET and individual working group members. Responses were collected using an online survey tool. Descriptive statistics were calculated.Results We analysed 1286 responses from 35/45 EULAR countries. Due to containment measures, 82% of respondents indicated cancellation/postponement of face-to-face visits of new patients (84% of them offering remote consultation) and 91% of follow-up visits (96% with remote consultation). The majority of respondents (58%) perceived that the interval between symptom onset and first rheumatological consultations was longer during containment restrictions than before. Treatment decisions were frequently postponed (34%), and the majority (74%) of respondents stated that it was less likely to start a biological disease modifying anti-rheumatic drug (DMARD)/targeted synthetic DMARD during the pandemic, mainly because of patients' fear, limited availability of screening procedures and decreased availability of rheumatological services. Use of (hydroxy)chloroquine (HCQ) and tocilizumab (TCZ) for the COVID-19 indication was reported by 47% and 42% of respondents, respectively, leading to a shortage of these drugs for RMDs indications according to 49% and 14% of respondents, respectively.Conclusion Measures related to containment of COVID-19 pandemic led to a perceived delay between symptom onset and a first rheumatological visit, postponement of treatment decisions, and shortage of HCQ and TCZ, thereby negatively impacting early treatment and treat-to-target strategies.