Concerns, Healthcare Use, and Treatment Interruptions in Patients With Common Autoimmune Rheumatic Diseases During the COVID-19 Pandemic.
Concerns, Healthcare Use, and Treatment Interruptions in Patients With Common Autoimmune Rheumatic Diseases During the COVID-19 Pandemic.
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DOI：
10.3899/jrheum.201017
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发表时间：
2021-04
期刊：
影响因子：
--
通讯作者：
Nowell WB
中科院分区：
文献类型：
--
作者：
George MD;Venkatachalam S;Banerjee S;Baker JF;Merkel PA;Gavigan K;Curtis D;Danila MI;Curtis JR;Nowell WB
目的：评估新冠肺炎大流行期间自身免疫性风湿病患者的关注点和医疗保健相关行为。来自美国的风湿性关节炎(RA)、牛皮癣关节炎(PSA)、强直性脊柱炎(AS)和系统性红斑狼疮(SLE)的成年人完成了调查。比较了不同自身免疫状况、疾病改良型抗风湿药的使用以及城市地位、收入、教育程度和新冠肺炎活动的地理指标的患者之间的担忧和行为。在1517名参与者(925名RA，299名PSA，185名AS，108名SLE)中，平均年龄为55.1岁，其中88.3%为女性，89.5%为白人。全国各地对新冠肺炎的担忧相似，在生物用户中的担忧程度更高(p<；0.001)。不去看医生(56.6%)或不做实验室检查(42.3%)和使用远程医疗(29.5%)在城市地区更常见。在没有新冠肺炎或其他呼吸道疾病的DMARDS参与者中，14.9%的人停止了DMARD，78.7%的DMARD中断不是医生建议的。社会经济地位较低的参与者以及避免去办公室就诊或报告缺乏远程医疗服务的参与者更常停止DMARD[OR 2.26(1.25-4.08)]。在新冠肺炎大流行的最初几个月，类风湿关节炎、前列腺癌、强直性脊柱炎和系统性红斑狼疮患者经常避免去办公室就诊和进行实验室检测。DMARD的中断通常在没有医生建议的情况下发生，并与社会经济状况、办公室访问和远程医疗可获得性有关，这突显了在大流行期间需要充分的医疗保健机会和对弱势人群的关注。
To assess concerns and healthcare-related behaviors of patients with autoimmune rheumatic diseases during the COVID-19 pandemic. 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 anti-rheumatic drug (DMARD) use, and geographic measures of urban status, income, education, and COVID-19 activity. Among 1,517 participants (925 RA, 299 PsA, 185 AS, 108 SLE), mean age was 55.1 years, 88.3% were female, and 89.5% 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 on DMARDs 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 participants with lower socioeconomic status and in participants who avoided an office visit [OR 1.46(1.04–2.04)] or reported lack of telehealth availability [OR 2.26(1.25–4.08)]. 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 socioeconomic status, office visits, and telehealth availability, highlighting the need for adequate healthcare access and attention to vulnerable populations during the pandemic.
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