Digital rheumatology in the era of COVID-19: results of a national patient and physician survey

Abstract

Objective: To analyse the impact of the COVID-19 pandemic on rheumatic patients' and rheumatologists' usage, preferences and perception of digital health applications (DHAs).

Methods: A web-based national survey was developed by the Working Group Young Rheumatology of the German Society for Rheumatology and the German League against Rheumatism. The prospective survey was distributed via social media (Twitter, Instagram and Facebook), QR code and email. Descriptive statistics were calculated, and regression analyses were performed to show correlations.

Results: We analysed the responses of 299 patients and 129 rheumatologists. Most patients (74%) and rheumatologists (76%) believed that DHAs are useful in the management of rheumatic and musculoskeletal diseases (RMDs) and felt confident in their own usage thereof (90%; 86%). 38% of patients and 71% of rheumatologists reported that their attitude had changed positively towards DHAs and that their usage had increased due to COVID-19 (29%; 48%). The majority in both groups agreed on implementing virtual visits for follow-up appointments in stable disease conditions. The most reported advantages of DHAs were usage independent of time and place (76.6%; 77.5%). The main barriers were a lack of information on suitable, available DHAs (58.5%; 41.9%), poor usability (42.1% of patients) and a lack of evidence supporting the effectiveness of DHAs (23.2% of rheumatologists). Only a minority (<10% in both groups) believed that digitalisation has a negative impact on the patient-doctor relationship.

Conclusion: The COVID-19 pandemic instigated an increase in patients' and rheumatologists' acceptance and usage of DHAs, possibly introducing a permanent paradigm shift in the management of RMDs.

Keywords: COVID-19; epidemiology; health services research; patient reported outcome measures.

Figure 1

Usage or recommendation of digital health applications. Patients and rheumatologists were asked to indicate the specific digital health applications (DHAs) they used or were recommended. Potential DHAs include digital information, symptom checkers, digital diaries, therapy and questionnaires, blood collection at home and video consultations. The percentage of patients and rheumatologists who indicated one of four levels of usage (planned, currently used, already used prior to COVID-19 or no interest) is shown.

Figure 2

Potential usage of video consultations in per cent. Rheumatologists and patients were asked about perceivable purposes of video consultations.

Figure 3

Percentage of rheumatologists and patients who are/are not willing to skip a real-life appointment and substitute it with a digital health application (DHA) in stable disease. Agreeing rheumatologists and patients were asked if they prefer time-synchronous or time-asynchronous DHAs.

Figure 4

Rheumatologists’ and patients’ attitudes towards digitisation and its effect on the patient–doctor relationship in per cent. Most frequently, both positive and negative aspects of digitisation were reported by rheumatologists and patients.