Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jan;7(1):e001505.
doi: 10.1136/rmdopen-2020-001505.

Self-protection strategies and health behaviour in patients with inflammatory rheumatic diseases during the COVID-19 pandemic: results and predictors in more than 12 000 patients with inflammatory rheumatic diseases followed in the Danish DANBIO registry

Bente Glintborg  1   2 , Dorte Vendelbo Jensen  3   4 , Sara Engel  5 , Lene Terslev  2   6 , Mogens Pfeiffer Jensen  2   6 , Oliver Hendricks  7   8 , Mikkel Ostergaard  5   2 , Simon Horskjær Rasmussen  6 , Thomas Adelsten  9 , Ada Colic  9 , Kamilla Danebod  6 , Malene Kildemand  10 , Anne Gitte Loft  11   12 , Heidi Lausten Munk  10   13 , Jens Kristian Pedersen  14 , René Drage Østgård  15 , Christian Møller Sørensen  16 , Niels Steen Krogh  17 , Jette Agerbo  18 , Connie Ziegler  18 , Merete Hetland  5   2
Affiliations

Self-protection strategies and health behaviour in patients with inflammatory rheumatic diseases during the COVID-19 pandemic: results and predictors in more than 12 000 patients with inflammatory rheumatic diseases followed in the Danish DANBIO registry

Bente Glintborg et al. RMD Open. 2021 Jan.

Abstract

Aims: In Danish patients with inflammatory rheumatic diseases to explore self-protection strategies and health behaviour including adherence to disease-modifying antirheumatic treatment (DMARD) during the initial phase of the COVID-19 pandemic and again after the reopening of the society started. Furthermore, to identify characteristics of patients with high levels of anxiety and self-isolation.

Methods: Patients in routine care followed prospectively in the nationwide DANBIO registry were invited to answer an online questionnaire regarding disease activity and COVID-19 infection, behaviour in March and June 2020. Responses were linked to patient data in DANBIO. Characteristics potentially associated with anxiety, self-isolation and medication adherence (gender/age/diagnosis/education/work status/comorbidity/DMARD/smoking/EQ-5D/disease activity) were explored with multivariable logistic regression analyses.

Results: We included 12 789 patients (8168 rheumatoid arthritis/2068 psoriatic arthritis/1758 axial spondyloarthritis/795 other) of whom 65% were women and 36% treated with biological DMARD. Self-reported COVID-19 prevalence was 0.3%. Patients reported that they were worried to get COVID-19 infection (March/June: 70%/45%) and self-isolated more than others of the same age (48%/38%). The fraction of patients who changed medication due to fear of COVID-19 were 4.1%/0.6%. Female gender, comorbidities, not working, lower education, biological treatment and poor European Quality of life, 5 dimensions were associated with both anxiety and self-isolation.

Conclusion: In >12 000 patients with inflammatory arthritis, we found widespread anxiety and self-isolation, but high medication adherence, in the initial phase of the COVID-19 pandemic. This persisted during the gradual opening of society during the following months. Attention to patients' anxiety and self-isolation is important during this and potential future epidemics.

Keywords: arthritis; epidemiology; health care; outcome assessment; patient reported outcome measures; rheumatoid.

PubMed Disclaimer

Conflict of interest statement

Competing interests: Bente Glintborg: Research grants: AbbVie, BMS, Pfizer.Oliver Hendricks: Research grants: AbbVie, Novartis, Pfizer.Lene Terslev: Speakers fee: Speakers fee from AbbVie, Janssen, Roche, Novartis, Pfizer, MSD, BMS and GE.Mikkel Østergaard: Research grants: Abbvie, BMS, Celgene, Merck, Novartis; Consultancy and/or speaker fees: Abbvie, BMS, Boehringer-Ingelheim, Celgene, Eli-Lilly, Hospira, Janssen, Merck, Novartis, Novo, Orion, Pfizer, Regeneron, Roche, Sandoz, Sanofi and UCB.Rene Østgaard: Research grants: Abbvie; Consultancy and/or speaker fees: Abbvie, BMS, Boehringer-Ingelheim, Eli-Lilly, Janssen, Merck, Novartis, Pfizer, Roche, Sanofi and UCB.Anne Gitte Loft: Consultancy and/or speakers fees: AbbVie, Eli-Lilly, Janssen, MSD, Novartis, Pfizer, and UCB.Merete Lund Hetland: AbbVie, Biogen, BMS, Celtrion, Eli Lilly Denmark A/S, Janssen Biologics B.V, Lundbeck Fonden, MSD, Pfizer, Roche, Samsung Biopis, Sandoz. MLH chairs the steering committee of the Danish Rheumatology Quality Registry (DANBIO), which receives public funding from the hospital owners and funding from pharmaceutical companies. MLH cochairs the EuroSpA research collaboration, which generates real-world evidence of treatment of psoriatic arthritis and axial spondyloarthritis based on secondary data and is partly funded by Novartis.Remaining authors: none declared.

Figures

Figure 1
Figure 1
Changes in self-isolation strategies and anxiety during the COVID-19 pandemic (March and June 2020). (A) ‘I consider myself at high risk of COVID-19 infection’. (B) ‘I worry more about COVID-19 than about my rheumatic disease’. (C) ‘I stay at home and avoid others as much as possible’. (D) ‘My arthritis causes me to self-isolate more than others my age’.
Figure 2
Figure 2
Changes in self-isolation strategies, anxiety and medication use during the pandemic (March and June 2020).
See this image and copyright information in PMC

References

    1. University and Medicine. Hopkins J. Coronavirus resource center. Available: https://coronavirus.jhu.edu/map.html [Accessed Oct 2020].
    1. Pablos JL, Galindo M, Carmona L, et al. . Clinical outcomes of hospitalised patients with COVID-19 and chronic inflammatory and autoimmune rheumatic diseases: a multicentric matched cohort study. Ann Rheum Dis 2020;79:1544–9. 10.1136/annrheumdis-2020-218296 - DOI - PubMed
    1. Sanchez-Piedra C, Diaz-Torne C, Manero J, et al. . Clinical features and outcomes of COVID-19 in patients with rheumatic diseases treated with biological and synthetic targeted therapies. Ann Rheum Dis 2020;79:988–90. 10.1136/annrheumdis-2020-217948 - DOI - PMC - PubMed
    1. Moiseev S, Avdeev S, Brovko M. Rheumatic diseases in intensive care unit patients with COVID-19. Ann Rheum Dis 2020. (Epub ahead of print: Oct 2020). - PubMed
    1. Antony A, Connelly K, De Silva T, et al. . Perspectives of patients with rheumatic diseases in the early phase of COVID-19. Arthritis Care Res 2020;72:1189–95. 10.1002/acr.24347 - DOI - PMC - PubMed

Publication types

MeSH terms

Substances

LinkOut - more resources