ABSTRACT
Dementia is a far-reaching disease and it is estimated that approximately 850,000 people are living with dementia in the UK;this is estimated to increase to over 1 million by the year 2025 (Prince, Knapp, Guerchet, et al., 2014). Caring for people with dementia is demanding and this care is often provided by unpaid carers in the home (National Institute for Health Research, 2016). So often people are uncertain about what the future could hold following diagnosis and how to support a person with dementia. Due to this in 2017, St Giles Hospice in collaboration with Green Square Accord launched a four-week carers' course which was designed to support unpaid carers in the community who support people living with dementia. The course covers a range of topics, including looking after yourself and activities for people with dementia, eating and drinking and infections in dementia, dementia related behaviours and planning for the future including end-of-life. Prior to 2020 this four-week course was face-to-face and was group based. When the COVID-19 pandemic hit the service had to act quickly to ensure the much-needed support for these carers did not disappear. The carers' course was adapted to provide support via a one-to-one basis either via video consultation or through a telephone call. This ensured that carers were not isolated and had access to specialist support and signposting to other services. Data captured showed that 100% of participants found that the topics covered were relevant to their situations, 92% of participants found that sessions fulfilled their expectations and that 100% were given opportunity to ask questions. Over 80 carers have been supported through the adaptation of the service so far.
ABSTRACT
Background: Many studies on COVID-19 outcomes in patients with RMD have either restricted to COVID positive RMD patients or compared them to the general clinic population as a comparator. Given heterogeneity in behaviors and risks, clinical characteristics associated with a positive diagnosis among patients with RMD seeking testing for Sars-CoV-2 remain less well studied. Objectives: Among patients with RMD receiving a Sars-CoV-2 PCR test, we aimed to identify RMD-related factors associated with a positive test result. Methods: Among patients seen at least once in the University of Washington (UW) rheumatology clinics between March 2018 to March 2020, we reviewed electronic medical records to identify patients undergoing Sars-CoV-2 PCR testing from March 1 through October 31, 2020. Patients with RMD were categorized into two groups: those who tested positive for Sars-CoV-2 and those who tested negative. We randomly selected patients from the negative group in a 2:1 ratio for further data abstraction. Student's t-test and Chi-squared tests were used to compare continuous and categorical variables, respectively, between the groups. To determine the correlates of testing positive for Sars-CoV-2, specifically RMD medication use and disease activity, we constructed different multivariable logistic regression models adjusted for age, sex, race/ethnicity, presence of comorbidities, body mass index, and smoking. Results: A total of 2768 RMD patients underwent SARS-CoV-2 PCR testing within the UW system, of whom 43 (1.5%) were positive at least once. Three patients with incomplete information were excluded. Patients who tested positive had higher prevalence of end stage renal disease (ESRD)/chronic kidney disease (CKD) (24% versus 11%), had higher rates of active disease (24% versus 20%), were older (>55 years) (mean age 57.3 versus 54.8 years), male (63% versus 55%), non-white race/ethnicity (32% versus 26%), and higher prevalence of multiple comorbidities (42% versus 31%) (Table 1). In the multivariable models, neither RMD medication use (versus no use, Table 1) nor high disease activity (vs low disease activity/remission) were statistically significantly associated with COVID-19 positivity. Among the 41 COVID-19 positive patients, a majority recovered without specific treatments, although approximately one third of the positive patients were hospitalized and three deaths were observed. Conclusion: In this study, patients who tested positive did not differ in many ways from those who tested negative. (Figure Presented).