George Michael D, Baker Joshua F, Banerjee Shubhasree, Busch Howard, Curtis David, Danila Maria I, Gavigan Kelly, Kirby Daniel, Merkel Peter A, Munoz George, Nowell William Benjamin, Stewart Patrick, Sunshine William, Venkatachalam Shilpa, Xie Fenglong, Curtis Jeffrey R
University of Pennsylvania, Philadelphia.
American Arthritis and Rheumatology Associates, Boca Raton.
ACR Open Rheumatol. 2021 Jun;3(6):381-389. doi: 10.1002/acr2.11239. Epub 2021 May 2.
We aimed to compare concerns, social distancing, health care disruptions, and telemedicine use in patients with autoimmune rheumatic disease (ARD) and non-ARD and to evaluate factors associated with immunomodulatory medication interruptions.
Patients in a multistate community rheumatology practice network completed surveys from April 2020 to May 2020. Adults with common ARD (rheumatoid arthritis, spondyloarthritis, systemic lupus erythematosus) or non-ARD (gout, osteoarthritis, osteoporosis) were evaluated. Concerns about coronavirus disease 2019 (COVID-19), social distancing, health care disruptions, and telemedicine use were compared in patients with ARD versus non-ARD, adjusting for demographics, rural residence, and zipcode-based measures of socioeconomic status and COVID-19 activity. Factors associated with medication interruptions were assessed in patients with ARD.
Surveys were completed by 2319/36 193 (6.4%) patients with non-ARD and 6885/64 303 (10.7%) with ARD. Concerns about COVID-19 and social distancing behaviors were similar in both groups, although patients receiving a biologic or Janus kinase (JAK) inhibitor reported greater concerns and were more likely to avoid friends/family, stores, or leaving the house. Patients with ARD were less likely to avoid office visits (45.2% vs. 51.0%, odds ratio [OR] 0.79 [0.70-0.89]) with similar telemedicine use. Immunomodulatory medications were stopped in 9.7% of patients with ARD, usually (86.9%) without a physician recommendation. Compared with patients with an office visit, the likelihood of stopping medication was higher for patients with a telemedicine visit (OR 1.54 [1.19-1.99]) but highest for patients with no visits (OR 2.26 [1.79-2.86]).
Patients with ARD and non-ARD reported similar concerns about COVID-19 and similar social distancing behaviors. Missed office visits were strongly associated with interruptions in immunomodulatory medication.
我们旨在比较自身免疫性风湿病（ARD）患者和非ARD患者的担忧、社交距离、医疗保健中断情况以及远程医疗的使用情况，并评估与免疫调节药物中断相关的因素。
2020年4月至2020年5月期间，多州社区风湿病实践网络中的患者完成了调查。对患有常见ARD（类风湿关节炎、脊柱关节炎、系统性红斑狼疮）或非ARD（痛风、骨关节炎、骨质疏松症）的成年人进行了评估。比较了ARD患者与非ARD患者对2019冠状病毒病（COVID-19）的担忧、社交距离、医疗保健中断情况以及远程医疗的使用情况，并对人口统计学、农村居住情况以及基于邮政编码的社会经济地位和COVID-19活动指标进行了调整。对ARD患者中与药物中断相关的因素进行了评估。
2319名非ARD患者（占36193名患者的6.4%）和6885名ARD患者（占64303名患者的10.7%）完成了调查。两组患者对COVID-19的担忧和社交距离行为相似，不过接受生物制剂或Janus激酶（JAK）抑制剂治疗的患者报告的担忧更大，且更有可能避免与朋友/家人接触、不去商店或不出门。ARD患者避免门诊就诊的可能性较小（45.2%对51.0%，优势比[OR]为0.79[0.70-0.89]），远程医疗的使用情况相似。9.7%的ARD患者停止使用免疫调节药物，通常（86.9%）是在没有医生建议的情况下。与门诊就诊的患者相比，远程医疗就诊的患者停止用药的可能性更高（OR为1.54[1.19-1.99]），但未就诊的患者停止用药的可能性最高（OR为2.26[1.79-2.86]）。
ARD患者和非ARD患者对COVID-19的担忧以及社交距离行为相似。错过门诊就诊与免疫调节药物中断密切相关。
