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1.
Ther Adv Musculoskelet Dis ; 14: 1759720X221096381, 2022.
Article in English | MEDLINE | ID: covidwho-1854584

ABSTRACT

Objective: To assess the management of gout in established COVID-19 pandemic. Methods: We assessed medication use, health care utilization, gout-specific health-related quality of life (HRQOL), psychological distress using Patient Health Questionnaire-4 (PHQ-4), resilience, illness perception, and health literacy in people with physician-diagnosed self-reported gout in established COVID-19 pandemic in a cross-sectional Internet survey. Results: Among the 130 survey respondents with gout, the mean age was 62.8 years, 65% were male, 83% were White, 59% were prescribed urate-lowering therapy (ULT), and health literacy was adequate in 80%. A third of survey respondents reported more difficulty with their gout management since September 2020. Gout-specific HRQOL deficits were evident. Moderate-severe psychological distress was seen in 22%, and resilience score was 6.5 [standard deviation (SD), 1.9; range, 0-8]. Adjusted for age and sex, compared with no/mild psychological distress, moderate-severe psychological distress was associated with significantly higher odds ratio (OR; 95% confidence interval) of more difficulty with (1) getting health care for gout in clinic, 3.7 (1.0, 13.2); emergency room/urgent care, 8.1 (1.4, 45.0); and in the hospital, 9.8 (1.6, 59.6); (2) getting gout flares treated, 6.6 (1.6, 26.8); (3) avoiding gout complications, 4.5 (1.2, 16.7); and (4) daily activities at home, 4.2 (1.3, 14.1), and performing work, 4.1 (1.2, 13.6). Conclusion: Respondents with gout reported health care gaps, low rates of ULT prescription, high psychological distress, and HRQOL deficits during established COVID-19 pandemic. Moderate-severe psychological distress was associated with difficulties in health care access and gout management. Interventions to address these challenges in gout management are needed.

2.
COVID-19 by Cases: A Pandemic Review ; : 247-259, 2021.
Article in English | Scopus | ID: covidwho-1837273
3.
Arthritis & Rheumatology ; 73:1382-1383, 2021.
Article in English | Web of Science | ID: covidwho-1728481
4.
European Journal of Public Health ; 31:273-273, 2021.
Article in English | Web of Science | ID: covidwho-1610126
5.
European Journal of Public Health ; 31, 2021.
Article in English | ProQuest Central | ID: covidwho-1514813

ABSTRACT

The COVID-19 pandemic has had a dramatic impact on workload and responsibilities for those working at primary health care (PHC) level in the European region - much of which has gone unnoticed relative to the focus on hospitals. Based on the PHC-relevant data extracted from the HSRM, we describe PHC models of care and the political and system levers that supported them. Three key themes emerged: (1) varied forms of PHC multidisciplinary collaboration were developed to manage the emergency response - supported by the movement of staff to areas requiring support;(2) vulnerable patients were identified and prioritized for medical outreach within PHC, and were supported through financial incentives and complementary action from centralized and local governments that used much broader definitions of vulnerability;and (3) digital solutions for remote triage, medical advice and treatment enhanced the effectiveness of the PHC response and were facilitated through centralized investment in digital technologies. Based on our analysis, we raise opportunities for the future of PHC, namely that multidisciplinary approaches to PHC service delivery are essential to future infectious and non-infectious outbreaks, and the agility and rapid pace of change that took place among PHC providers should continue. PHC providers lacked visibility during the pandemic and should work together to develop a strong voice in all health systems.

6.
COVID-19 by Cases: A Pandemic Review ; : 249-262, 2021.
Article in English | Scopus | ID: covidwho-1339901
9.
10.
Eurohealth ; 26(2):68-72, 2020.
Article in English | GIM | ID: covidwho-942065

ABSTRACT

During the COVID-19 pandemic, hospitals face the concurrent challenges of maintaining routine services while attending to COVID-19 patients. This article shares approaches taken in six countries to resume hospital care after the first wave of the pandemic by surveying country experts and using data extracted from the COVID-19 Health Systems Response Monitor (HSRM). Four strategies were observed in all six countries: prioritisation or rationing of treatments, converting clinical spaces to separate patients, using virtual treatments, and implementing COVID-19 free hospitals or floors. Clear guidance about how to prioritise activities would support hospitals in the next phases of the pandemic.

11.
Ther Adv Musculoskelet Dis ; 12: 1759720X20966124, 2020.
Article in English | MEDLINE | ID: covidwho-885916

ABSTRACT

AIM: We aimed to assess the gout management during the COVID-19 pandemic. METHODS: We assessed medication use, healthcare utilization, gout-specific health-related quality of life (HRQoL) on the Gout Impact Scale (GIS), psychological distress using the patient health questionnaire-4 (PHQ-4), and resilience in people with self-reported physician-diagnosed gout during the COVID-19 pandemic in a cross-sectional Internet survey. RESULTS: Among the 122 survey respondents with physician-diagnosed gout, 82% were prescribed urate-lowering therapy (ULT) and 66% were taking ULT daily; mean age was 54.2 years [standard deviation (SD), 13.8], 65% were male, and 79% were White. More regular use of gout medication was reported during the COVID-19 pandemic: allopurinol, 44%; colchicine, 37%; non-steroidal anti-inflammatory drugs, 36%. Gout flares were common: 63% had ⩾1 gout flare monthly; 11% went to emergency room/urgent care; and 2% were hospitalized with gout flares. Between 41% and 56% of respondents reported more difficulty with gout management and related functional status related to COVID-19; 17-37% had difficulty with healthcare access for gout. HRQOL deficits were evident for gout concern overall, 79.4 (SD, 25); unmet gout treatment need, 64.5 (SD, 27.1); and gout concern during flare, 67.3 (SD, 27.1); but less so for gout medication side effects, 48.9 (SD, 27.4). Psychological distress was moderate in 19% and severe in 15% (mild, 22%; normal, 45%). Resilience score on Connor-Davidson Resilience Scale (CD-RISC2) was 5.6 (SD, 1.8; range 0-8). Compared with no/mild psychological distress, moderate-severe psychological distress during the COVID-19 pandemic was significantly associated with more difficulty getting gout medication filled (p = 0.02), flares treated (p = 0.005), and receiving gout education (p = 0.001). CONCLUSION: Healthcare gaps, psychological distress, and HRQoL deficits were commonly reported by people with gout during the COVID-19 pandemic. Interventions to address these challenges for people with gout during the COVID-19 pandemic are needed.

12.
in English | WHO COVID, ELSEVIER | ID: covidwho-710790

ABSTRACT

Background: Long-term (defined as >1 month) oral corticosteroids are widely used for chronic inflammatory and autoimmune conditions. In cardiology, the primary indications are transplantation, cardiac sarcoidosis and large vessel vasculitis. Minimising organ-based complications including infection (Pneumocystis jiroveci pneumonia (PJP)), gastro-intestinal (GI) bleeding and osteoporosis warrant consideration but guidelines vary between specialties and co-existing treatments. The aim of this study was to assess prescribing patterns between specialties at Auckland, Waitemata and Counties Manukau District Health Boards. Method: An anonymised survey of cardiologists, respiratory, oncology, haematology, endocrinology, infectious diseases and rheumatologists with questions regarding prescribing and monitoring practices for: i) PJP prophylaxis, ii) proton pump inhibitor (PPI) for GI protection, iii) baseline bone mineral density (BMD) and iv) bisphosphonate use. Results: In total 44 responders; cardiology n=16 vs. other n=28. PJP prophylaxis was prescribed n= 5 (31%) of cardiologists compared to n=23 (96%) of other specialties. Cardiologists were less likely to prescribe bisphosphonates n=1 (6%) than other specialists n=10 (36%, p value = 0.01) but with similar prescription of PPI and baseline BMD (Figure 1). Conclusion: Prescription of PJP prophylaxis, bisphosphonates and PPIs are lower amongst cardiologists. PPI and bisphosphonates use were high particularly amongst non-cardiologists increasing the patient pill burden but may be unnecessary in the absence of previous GI complications or co-existing NSAID use and moderate-high risk of fracture on BMD. Consensus guidelines for cardiologists aimed at standardising pre-treatment assessment and prevention of prove patient care and prevent unnecessary therapy. [Formula presented]

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