ABSTRACT
Objectives: To determine the leading causes for non-adherence to rheumatology consults in a tertiary care hospital. Method(s): Patients who did not show up for their programmed consult were identified using the rheumatology service database, from January 2021 to July 2022, and they were contacted by telephone to determine reasons for their absence. Result(s): During 2021, we identified 2487 patients who did not show for their rheumatology consult. Sixty percent of patients referred that their absence was related to COVID-19 (38% were sick or in contact with a sick relative, and 22% were afraid of getting sick). Meanwhile, 40% mentioned different reasons: 10% have economic problems, and 30% forgot their consult date. On the other hand, during January-July 2022 period, 1529 patients were identified as no shows for their rheumatology consult. Seventy percent of these patients satted that economic problems were the main cause (impossibility to pay for transportation, consultation, requested studies and/or treatment), while 15% said that they forgot about their appointment date, and the other 15% referred to a reason related to the pandemic (mostly, afraid of getting sick with COVID-19). Conclusion(s): The COVID-19 pandemic harmed consult adherence in rheumatology. Initially, this problem was caused by pandemic-related issues, however, reasons for these 'no shows' have changed, being more recently economic troubles the leading cause, which was induced by the pandemic.
ABSTRACT
Background: One of the greatest challenges of the COVID-19 pandemic for rheumatologists concerns the patient's adherence to treatment (1). The impact of poor adherence on the effectiveness of chronic disease treatment is severe in terms of poorer health outcomes and increased health care costs (2). Information regarding covid-19 on adherence behavior in Latin-American is scarce. Objectives: The aim of this study is to describe impact of COVID-19 outbreak on adherence behavior in Latin-American population with rheumatic diseases. Methods: We carried out a descriptive, cross-sectional, self-report study through voluntary telephonic survey, to determine adherence behaviors during the COVID-19 pandemic, from September 9th, 2020 to November 19th, 2020, for consecutive patients of the outpatient rheumatology clinic in the Hospital Universitario (Monterrey, Nuevo Leon, Mexico), which serves a resource limited population that lack access to health insurance, from five neighboring states. A 17-items survey was designed. Baseline demographics that were collected included age, sex, rheumatologic diagnosis, current medications and patient perception of disease control. Patients were asked if they continued follow-up care, last prescribed therapy and reasons. Also, the survey assessed whether patients had any issues with medication supply and where they were obtaining information about covid-19 (could choose as many options as applicable). Transferred to SPSS for analysis for descriptive statistics. Results: A total of 150 patients were called, the survey response rate was 54.6% (n=82), with a mean completion time of 10 minutes. The mean +/-SD age of the participants was 52 +/-15.9 years, and 95% were female. The most common self-reported diagnoses were rheumatoid arthritis (RA) (13.4%) and systemic lupus erythematosus (SLE) (13.4%) [Table 1]. Patient perception of disease control was primary good 37.8% and regular 35.4%. Patients that continued their follow-up with their rheumatologist (on the clinic face-to-face, electronically or telehealth) or in another clinic were 26.9%, the majority were nonadherent 73%. Persistence to treatment was 82.9%, the main reason to discontinue therapy was lack of prescriptions or medical advice 8.5% and overall 58.5% had trouble finding their medicine. Information regarding covid-19 was mainly obtained by television (health secretary conference) 90.2%, and the least directly from their doctor 4.8%. Conclusion: Patients continue their therapeutic regimen, still many of them have trouble finding their medications, which affects the disease control. Also, despite having a poor disease control (majority between regular and bad) they are not continuing their follow-up care, more objective studies are needed to determine a specific cause. (Table Presented).
ABSTRACT
Background: The pandemic COVID-19 has set a new challenge in adherence to treatment in patients with rheumatic diseases. Prior studies in Latin America had reported adherence of 16.4% on Rheumatoid Arthritis (RA) and 45.9% in Systemic Lupus Erythematous (SLE). There is evidence that these patients believe their treatment increases the risk and gravity of COVID-19 and therefore, suspending the treatment could reduce this risk. It has been shown that a Good adherence is associated to a better survival. Objectives: Describe the adherence to DMARDs in patients with Rheumatic diseases during COVID-19. Methods: Descriptive, cross-sectional, self-report study conducted in rheumatology outpatient clinic of University Hospital in Monterrey, México. Consecutive patients with RA, SLE, Inflammatory Myopathies and Systemic Sclerosis, were approached during their routine appointments, March 2020 to December 2020 period during COVID-19 pandemic. They were asked how many days of the month they took the DMARD indicated in the previous appointment, with Based on this, adherence was classified into four categories: Good 100-75% (> 21 days), Regular 74-50% (21-15 days), Bad 49-25% (14-8 days) and Null <25% (<7 days). Data was obtained from our internal electronic patient record registry and analyzed with SPSS V.22. RESULTS: Conclusion: Despite what it is believed, patients are not changing therapeutic regimes. The adherence found in this group of patients was good, for the definition used in this study. It should be considered that the self-report method may overestimate adherence, so the data found must be correlated with objective methods in the future.