ABSTRACT
Background: Digital health applications (DHAs) are gaining influence and promise great potential for the monitoring and management of rheumatic and musculoskeletal diseases (RMDs). Objectives: To analyse the impact of the COVID-19 pandemic on RMD patients' and rheumatologists' usage, preferences, and perception of digital health applications (DHAs) in Germany. Methods: A web-based national survey was developed by the Working Group Young Rheumatology of the German Society for Rheumatology and the German League against Rheumatism. The prospective survey was distributed via social media, QR-code, and email. Descriptive statistics were calculated, and regression analyses were performed to show correlations. Results: We analysed the responses of 299 patients and 129 rheumatologists. Most patients (74%) and rheumatologists (76%) believed that DHAs are useful in the management of RMDs and felt confident in their own usage thereof (90%;86%). 38% of patients and 71% of rheumatologists reported that their attitude had changed positively towards DHAs and that their usage had increased due to COVID-19 (29%;48%). The majority in both groups agreed on implementing virtual visits for follow-up appointments in stable disease conditions. The most reported advantages of DHAs were usage independent of time and place (76.6%;77.5%). The main barriers were a lack of information on suitable, available DHAs (58.5%;41.9%), poor usability (42.1% of patients) and a lack of evidence supporting the effectiveness of DHAs (23.2% of rheumatologists) (Table 1). Only a minority (<10% in both groups) believed that digitalisation has a negative impact on the patient-doctor relationship. Conclusion: The COVID-19 pandemic instigated an increase in patients' and rheumatologists' acceptance and usage of DHAs, possibly introducing a permanent paradigm shift in the management of RMDs. (Table Presented).
ABSTRACT
BACKGROUND: The preparations of healthcare systems to accommodate the large numbers of severely ill COVID-19 patients in March/April 2020 also had a substantial impact on rheumatological patient care. OBJECTIVE: The aim of this online survey was to assess the changes and current status of rheumatology departments and practices in Germany. MATERIAL AND METHODS: A web-based questionnaire was designed to differentiate the impact of the pandemic on inpatient and outpatient operations. Questions addressed the following issues: characteristics of the department, impact on patient care, application of recommendations, personal protective equipment (PPE), and organizational adaptations to the new framework conditions. The survey was available for 14 days and closed on 3 May 2020. RESULTS: A total of 66 complete answers were recorded and evaluated. In the first 4 weeks of the COVID-19 crisis the proportion of outpatients in the institutions decreased on average by -40.6%. The number of outpatients receiving infusions decreased by -25.6%. Of the inpatient facilities 81% reported an average decrease of hospitalized patients of -54.9% and 52% of the participants complained of a lack of PPE. Organizational adjustments are reported. CONCLUSION: The rheumatological services were significantly reduced 4 weeks after the SARS-CoV2 pandemic had reached Germany on a large scale. The study showed that in this phase there were decisive turning points in patient care and implicated substantial organizational and ultimately also economic effects on the healthcare system, both in hospitals and private practices. As the survey cannot adapt to the daily dynamic changes in priorities it serves as a first snapshot, which requires follow-up studies.