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[通过远程医疗治疗的类风湿性关节炎患者在SARS-CoV-2大流行期间自我护理、生活质量和治疗依从性的改变]

[Modifications in self-care, quality of life and therapeutic adherence in patients with rheumatoid arthritis during the SARS-CoV-2 pandemic treated by telehealth].

作者信息

Hernández-Zambrano Sandra Milena, Castiblanco-Montañez Ruth-Alexandra, Valencia Serna Angie Marcela, Nonzoque Toro Valentina, Sánchez Camargo Maria Paula, Restrepo Rodríguez Leidy Natalia, Rodríguez-Vargas Gabriel-Santiago, Villareal Laura, Rubio-Rubio Jaime-Andrés, Quintero-Muñoz Elías, Gómez Pineda María Alejandra, Chávez-Chavéz Josefina, Rivera-Triana Diana, Casanova Rosangela, Rojas-Villarraga Adriana, Santos-Moreno Pedro

机构信息

Facultad de Enfermería, Grupo de Investigación Perspectivas del Cuidado, Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, Colombia.

Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, Colombia.

出版信息

Rev Colomb Reumatol. 2022 Oct-Dec;29(4):293-302. doi: 10.1016/j.rcreu.2022.03.009. Epub 2022 May 5.

Abstract

INTRODUCTION

Rheumatoid arthritis (RA) is an autoimmune disease characterized by chronic inflammation, causing pain and stiffness in the joints. SARS-CoV-2 increases the clinical vulnerability of the population with RA and has led to the implementation and/or development of telemedicine.

OBJECTIVE

To describe changes in level of therapeutic adherence, quality of life and capacity for self-care agency, during the follow-up period of a group of patients linked to a non-face-to-face multidisciplinary consultation model during the SARS-CoV-2 pandemic.

METHODOLOGY

Descriptive cohort study (July to October 2020). Description of the level of therapeutic adherence (Morisky Green Test), quality of life (EuroQOL-5-Dimensions-3-Level-version) and self-care capacity (ASA-R Scale) in the context of a telehealth model. A univariate and bivariate analysis was performed (Stata Software, Considered p-value <.05).

RESULTS

Of 71 patients treated under the telehealth model, 85.9% were women, the age range was between 33 and 86 years with a median of 63. The most prevalent comorbidity was arterial hypertension (35.2%). Quality of life did not change during follow-up nor did adherence to treatment, apart from in one item [the patients did not stop taking the medication when they were well (=.029)]. In self-care capacity, there were significant improvements in five dimensions (<.05), without significant differences in the global score.

CONCLUSION

Patients with RA evaluated in the context of telehealth in a period of pandemic did not present significant changes in quality of life, adherence to treatment, or capacity for self-care, and remained close to baseline values when they attended a traditional face-to-face assessment.

摘要

引言

类风湿性关节炎(RA)是一种以慢性炎症为特征的自身免疫性疾病,会导致关节疼痛和僵硬。严重急性呼吸综合征冠状病毒2(SARS-CoV-2)增加了类风湿性关节炎患者群体的临床易感性,并促使远程医疗得以实施和/或发展。

目的

描述在SARS-CoV-2大流行期间,一组与非面对面多学科咨询模式相关的患者在随访期间治疗依从性水平、生活质量和自我护理能力的变化。

方法

描述性队列研究(2020年7月至10月)。在远程医疗模式下描述治疗依从性水平(Morisky Green测试)、生活质量(欧洲五维健康量表-3水平版)和自我护理能力(ASA-R量表)。进行单变量和双变量分析(Stata软件,p值<.05)。

结果

在远程医疗模式下接受治疗的71名患者中,85.9%为女性,年龄范围在33岁至86岁之间,中位数为63岁。最常见的合并症是动脉高血压(35.2%)。随访期间生活质量和治疗依从性均未改变,但有一项除外[患者病情好转时未停药(p =.029)]。在自我护理能力方面,五个维度有显著改善(p<.05),总体评分无显著差异。

结论

在大流行期间接受远程医疗评估的类风湿性关节炎患者在生活质量、治疗依从性或自我护理能力方面没有显著变化,在接受传统面对面评估时仍接近基线值。

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本文引用的文献

1
Tele-Rheumatology During the COVID-19 Pandemic.COVID-19大流行期间的远程风湿病学
Reumatol Clin (Engl Ed). 2020 Oct 29;18(3):157-63. doi: 10.1016/j.reuma.2020.10.004.
4
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COVID-19 infection and rheumatoid arthritis: Faraway, so close!COVID-19 感染与类风湿关节炎:远在天边,近在咫尺!
Autoimmun Rev. 2020 May;19(5):102523. doi: 10.1016/j.autrev.2020.102523. Epub 2020 Mar 20.

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