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COVID-19 大流行期间炎症性关节炎患者使用远程医疗:一项真实环境中可行性和对患者报告结局影响的回顾性研究。

Use of telemedicine during the COVID-19 pandemic in patients with inflammatory arthritis: a retrospective study on feasibility and impact on patient-reported outcomes in a real-life setting.

机构信息

Division of Rheumatology, Multispecialist Medical Department, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.

出版信息

Rheumatol Int. 2021 Jul;41(7):1253-1261. doi: 10.1007/s00296-021-04863-x. Epub 2021 May 4.

Abstract

Close follow-up is mandatory in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS). During the Coronavirus Disease 2019 (COVID-19) pandemic, rheumatological care was rapidly reorganized during the first peak from March 1, 2020 to May 31, 2020, and all patients with RA, PsA, and AS being treated with a subcutaneous biologic disease-modifying anti-rheumatic drug or oral targeted synthetic disease-modifying anti-rheumatic drug were followed remotely. A retrospective database analysis of these 431 patients before and after this period is presented herein. A rheumatologist directly contacted all patients by telephone. Patients could also enter data on patient-reported outcomes remotely using the digital platform iAR Plus. General health (GH) and visual analog scale (VAS) pain were the main outcomes along with FACIT and disease-specific questionnaires (RADAI, ROAD, PROCLARA for RA, and BASDAI, BASGI, BASFI for AS). In all, 449 visits were postponed (69.9% of all scheduled visits); telephone evaluation was deemed inadequate in 193 instances, and patients underwent a standard outpatient visit. Comparing patients on telemedicine to those who underwent hospital visits, we found no statistically significant differences in GH (35.3 vs 39.3; p = 0.24), VAS (33.3 vs 37.1; p = 0.29), or other specific outcome measures in patients with RA, PsA, or AS. These results show that telemedicine has undoubted benefits, and in light of the ongoing COVID-19 pandemic, it is likely that many patients with these diseases may prefer it.

摘要

密切随访是类风湿关节炎(RA)、银屑病关节炎(PsA)和强直性脊柱炎(AS)患者的强制性要求。在 2019 年冠状病毒病(COVID-19)大流行期间,从 2020 年 3 月 1 日至 2020 年 5 月 31 日,第一波疫情高峰期迅速对风湿病学护理进行了重新组织,所有接受皮下生物改良抗风湿药物或口服靶向合成改良抗风湿药物治疗的 RA、PsA 和 AS 患者均接受远程随访。本文报告了在此期间前后对这 431 例患者的回顾性数据库分析。风湿病专家通过电话直接联系所有患者。患者也可以使用数字平台 iAR Plus 远程输入患者报告的结果数据。一般健康(GH)和视觉模拟量表(VAS)疼痛是主要结局,同时还包括 FACIT 和疾病特异性问卷(RADAI、ROAD、PROCLARA 用于 RA,BASDAI、BASGI、BASFI 用于 AS)。共有 449 次就诊被推迟(所有预约就诊的 69.9%);193 次电话评估被认为不充分,患者接受了标准的门诊就诊。与接受远程医疗的患者相比,接受医院就诊的患者在 GH(35.3 对 39.3;p=0.24)、VAS(33.3 对 37.1;p=0.29)或其他特定结局测量方面没有统计学差异 RA、PsA 或 AS 患者。这些结果表明,远程医疗具有明显的优势,而且鉴于 COVID-19 大流行仍在继续,许多患有这些疾病的患者可能会更喜欢这种方式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9370/8095216/d26481d8a37f/296_2021_4863_Fig1_HTML.jpg

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