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. 2021 Apr;48(4):603-607.
doi: 10.3899/jrheum.201017. Epub 2020 Nov 15.

Concerns, Healthcare Use, and Treatment Interruptions in Patients With Common Autoimmune Rheumatic Diseases During the COVID-19 Pandemic

Michael D George  1 , Shilpa Venkatachalam  2 , Shubhasree Banerjee  3 , Joshua F Baker  3 , Peter A Merkel  3 , Kelly Gavigan  2 , David Curtis  2 , Maria I Danila  4 , Jeffrey R Curtis  4 , W Benjamin Nowell  2
Affiliations

Concerns, Healthcare Use, and Treatment Interruptions in Patients With Common Autoimmune Rheumatic Diseases During the COVID-19 Pandemic

Michael D George et al. J Rheumatol. 2021 Apr.

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.

Keywords: COVID-19; antirheumatic drugs; health behavior; rheumatoid arthritis; spondyloarthritis; systemic lupus erythematosus.

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Figures

Figure 1:
Figure 1:. Location of participants and concerns about COVID-19.
Number of participants by state/territory are shown. Colors represent median participant concern about COVID-19 in each state on a 5-point Likert scale, excluding states with <5 participants.
See this image and copyright information in PMC

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