Hospital for Special Surgery, New York, New York, USA
Weill Cornell Medical College, New York, New York, USA.
RMD Open. 2020 Oct;6(3). doi: 10.1136/rmdopen-2020-001378.
There is emerging evidence that COVID-19 disproportionately affects people from racial/ethnic minority and low socioeconomic status (SES) groups. Many physicians across the globe are changing practice patterns in response to the COVID-19 pandemic. We sought to examine the practice changes among rheumatologists and what they perceive the impact to be on their most vulnerable patients.
We administered an online survey to a convenience sample of rheumatologists worldwide during the initial height of the pandemic (between 8 April and 4 May 2020) via social media and group emails. We surveyed rheumatologists about their opinions regarding patients from low SES and racial/ethnic minority groups in the context of the COVID-19 pandemic. Mainly, what their specific concerns were, including the challenges of medication access; and about specific social factors (health literacy, poverty, food insecurity, access to telehealth video) that may be complicating the management of rheumatologic conditions during this time.
548 rheumatologists responded from 64 countries and shared concerns of food insecurity, low health literacy, poverty and factors that preclude social distancing such as working and dense housing conditions among their patients. Although 82% of rheumatologists had switched to telehealth video, 17% of respondents estimated that about a quarter of their patients did not have access to telehealth video, especially those from below the poverty line. The majority of respondents believed these vulnerable patients, from racial/ethnic minorities and from low SES groups, would do worse, in terms of morbidity and mortality, during the pandemic.
In this sample of rheumatologists from 64 countries, there is a clear shift in practice to telehealth video consultations and widespread concern for socially and economically vulnerable patients with rheumatic disease.
有新的证据表明，COVID-19 disproportionately 影响来自种族/族裔少数群体和低社会经济地位（SES）群体的人。全球许多医生正在改变实践模式以应对 COVID-19 大流行。我们试图研究风湿病学家的实践变化，以及他们认为这些变化对他们最弱势的患者有何影响。
我们在大流行初期（2020 年 4 月 8 日至 5 月 4 日之间）通过社交媒体和群组电子邮件向全球范围内的风湿病学家进行了一项在线调查。我们调查了风湿病学家在 COVID-19 大流行背景下对来自低 SES 和种族/族裔少数群体患者的看法。主要是他们的具体关注点是什么，包括药物获取方面的挑战；以及可能使在此期间管理风湿病状况变得复杂的特定社会因素（健康素养、贫困、粮食不安全、远程医疗视频获取）。
来自 64 个国家的 548 名风湿病学家做出了回应，并对他们的患者存在的粮食不安全、低健康素养、贫困和妨碍社交距离的因素表示担忧，例如工作和住房密集。尽管 82%的风湿病学家已经转向远程医疗视频，但 17%的受访者估计约有四分之一的患者无法获得远程医疗视频，尤其是那些处于贫困线以下的患者。大多数受访者认为，在大流行期间，这些弱势群体（来自种族/族裔少数群体和来自低 SES 群体）在发病率和死亡率方面会更糟。
在来自 64 个国家的风湿病学家样本中，向远程医疗视频咨询的实践明显转变，并且广泛关注患有风湿性疾病的社会和经济弱势患者。
