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J Rheumatol ; 49(4): 424-431, 2022 04.
Article in English | MEDLINE | ID: covidwho-1674899

ABSTRACT

OBJECTIVE: To assess rheumatology provider experience and practices at Veterans Affairs (VA) facilities during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: We performed an anonymized follow-up national cross-sectional survey (November 5, 2020 to January 1, 2021) to assess provider resilience, experience, practices, views, and opinions about changes to medications and laboratory monitoring of veterans with rheumatic diseases. RESULTS: Of the 143 eligible VA rheumatology providers, 114 (80%) responded. Compared to the original survey, fewer providers reported using telephone visits (78% vs 91%, P = 0.009), and more used clinical video telehealth (CVT; 16% vs 7%, P = 0.04) or in-person visits (76% vs 59%, P = 0.007). Most providers were somewhat or very comfortable with the quality of clinical encounters for established but not new patients for telephone, video-based VA Video Connect (VVC), and CVT. The mean 2-item Connor-Davidson Resilience Scale score was 6.85 (SD 1.06, range 0-8), significantly higher than the original April-May 2020 survey score of 6.35 (SD 1.26; P = 0.004). When adjusted for age, sex, and ethnicity, high provider resilience was associated with significantly higher odds of comfort with technology and the quality of the VVC visit for the following: (1) established patients (odds ratio [OR] 1.72, 95% CI, 0.67-4.40 and OR 4.13, 95% CI 1.49-11.44, respectively) and (2) new patients (OR 2.79, 95% CI 1.11-7.05, and OR 2.69, 95% CI 1.06-6.82, respectively). CONCLUSION: Reassuringly, VA rheumatology providers became increasingly comfortable with video visits during the first 10 months of the COVID-19 pandemic. High provider resilience, and its association with better quality CVTs, raise the possibility that video visits might be an acceptable substitute for in-person visits under appropriate circumstances.


Subject(s)
COVID-19 , Rheumatology , Telemedicine , Veterans , COVID-19/epidemiology , Cross-Sectional Studies , Follow-Up Studies , Humans , Pandemics
2.
Arthritis Care Res (Hoboken) ; 73(7): 998-1003, 2021 07.
Article in English | MEDLINE | ID: covidwho-1017881

ABSTRACT

OBJECTIVE: To assess the experience, views, and opinions of rheumatology providers at Veterans Affairs (VA) facilities about rheumatic disease health care issues during the COVID-19 pandemic. METHODS: We performed an anonymized cross-sectional survey, conducted from April 16 to May 18, 2020, of VA rheumatology providers. We assessed provider perspectives on COVID-19 issues and resilience. RESULTS: Of the 153 eligible VA rheumatologists, 103 (67%) completed the survey. A significant proportion of providers reported a ≥50% increase related to COVID-19 in visits by telephone (53%), video-based VA video connect (VVC; 44%), and clinical video telehealth with a facilitator (29%). A majority of the responders were somewhat or very comfortable with technology for providing health care to established patients during the COVID-19 pandemic using telephone (87%), VVC (64%), and in-person visits (54%). A smaller proportion were comfortable with technology providing health care to new patients. At least 65% of rheumatologists considered telephone visits appropriate for established patients with gout, osteoporosis, polymyalgia rheumatica, stable rheumatoid arthritis, stable spondyloarthritis, or osteoarthritis; 32% reported a rheumatology medication shortage. Adjusted for age, sex, and ethnicity, high provider resilience was associated with significantly higher odds ratios (ORs) of comfort with technology for telephone (OR 3.1 [95% confidence interval (95% CI) 1.1-9.7]) and VVC visits for new patients (OR 4.7 [95% CI 1.4-15.7]). CONCLUSION: A better understanding of COVID-19 rheumatic disease health care issues using a health-system approach can better inform providers, improve provider satisfaction, and have positive effects on the care of veterans with rheumatic disease.


Subject(s)
COVID-19 , Practice Patterns, Physicians'/trends , Rheumatic Diseases/therapy , Rheumatologists/trends , Rheumatology/trends , Telemedicine/trends , United States Department of Veterans Affairs/trends , Attitude of Health Personnel , Attitude to Computers , Cross-Sectional Studies , Female , Health Care Surveys , Health Knowledge, Attitudes, Practice , Humans , Male , Middle Aged , Rheumatic Diseases/diagnosis , Time Factors , United States
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