RHEUMATIC MUSCULOSKELETAL DISEASES (RMDS) during the FIRST WAVE of the COVID19 PANDEMIC: PATIENTS' POINT of VIEW on the ROLE of TELEMEDICINE

ABSTRACT

Background: The COVID19 pandemic has caused health problems in people's daily lives with a signifcant psychological impact. In fact, patients with RMDs have experienced diseases' fare and also psychological problems. The lockdown and the 'social quality changes' have impacted the life and the well-being of RMDs patients, influencing directly the implementation of telemedicine during daily practice. Objectives: A descriptive observational study was designed to analyse the short-term effect of the frst wave on RMDs patients on social quality changes and the usefulness of telemedicine. Methods: The survey was carried out by administering a questionnaire consisting of 30 questions, developed ad hoc using Likert scales. Items such as family and work environment, access to healthcare facilities, healthcare provided to the patient, disease activity and the mental health status of individuals (anxiety/depressive symptoms) were investigated. Preliminary data on the frst wave were collected between September and November 2021 through patient associations and social networks. Results: 40 RMDs patients (Rheumatoid Arthritis 57.5%, Psoriatic Arthritis 35%, Fibromyalgia and others 7.5%) prevalently women (97.5%) were included in the survey. During the pandemic, 72% of respondents reported cancellation or delays in scheduled appointments and 50% did not have alternative contacts (telephone consultations, e-mail prescriptions, telematics training) with the hospital. 40.5% of patients reported difficulty in fnding DMARDs and material for the treatment of ulcers, 28.2% reported difficulties in accessing the health facilities. In particular, 34.2% reported the total closure of the hospital facilities. Moreover, our data show a worsening of health status due to an increased anxiety concerning the management of their RMDs, an increased stress within the family, a reduced access to care facilities due to their closure or travel restrictions. In 57% of patients, a worsening of health status was reported, while in 90% stress and a feeling of abandonment was developed since the beginning of the pandemic. In this context, telemedicine was considered useful by 97.5% of patients, although patients felt that an improvement was necessary with an integration with the regular follow up. Conclusion: Patients with RMDs reported that the signifcant delays or cancellation of the outpatient visits provoked an increase of stress, worry and anxiety for their health. The majority was very concerned about the overall management of their RMDs. The worsening of symptoms in more than half of the patients was the most worrisome observation. Almost all patients agreed that Telemedicine might help the clinical evaluation of their RMDs, also providing a signifcant support to their psychological condition because of the direct contact with the caring physician and health professionals.