THE IMPACT of TELEMEDICINE CONSULTATIONS for RHEUMATOID ARTHRITIS, GIANT CELL ARTERITIS, OSTEOARTHRITIS and CRYSTAL ARTHRITIS during COVID19 PANDEMIC

ABSTRACT

Background: Rheumatology departments across the UK have adapted to the COVID-19 pandemic, implementing novel methods of working via remote consultations. Objectives: We wanted to explore the rates of telemedicine consultations for patients with Rheumatoid Arthritis (RA), Giant cell arteritis (GCA), Osteoarthritis (OA), and Crystal arthritis (CA). We also wanted to check how effective the tele-medicine consultations had been in terms of avoiding the need for a face-to-face appointment. Methods: No telemedicine consultations took place before the COVID-19 pandemic in patients diagnosed with GCA, RA, CA and OA. We assessed the number of telemedicine consultations (telephone or videocall) using data from the departmental database covering September 2020 to December 2021. We analysed the rates of face-to-face versus telemedicine appointments for both new referrals and follow-up consultations. The statistical analysis was conducted using chi-square test. Results: There were 20,648 patients assessed in our department from September 2020 to December 2021. In total 1786 face-to-face and 2079 telemedi-cine consultations were conducted for GCA (18%), RA (66%), OA (13%) and CA (3%). The highest percentage of telemedicine consultations versus face-to-face for new referrals were observed for OA (30% Vs 70%) followed by RA (14% Vs 86%), CA (12% Vs 88%) and GCA (2% Vs 98%) (Table 1). Combining all these conditions, 68% of clinicians felt the telemedicine appointment avoided a face-to-face appointment. However, 33% of clinicians seeing new patients with RA did not feel the telemedicine appointment avoided a face-to-face appointment. In contrast, follow-up appointments were mainly conducted by telemedicine when compared with face-to-face;RA (65% Vs 35%), GCA (53%Vs 47%), OA (51% Vs 49%) and CA (61% Vs 39%). For the follow-ups, an overall majority of 90% of telemedicine consultations avoided the need for a face-to-face appointment, particularly observed for patients with CA and GCA (98% and 93% respectively). We noted that patients with RA were more likely than GCA to have a telemedicine follow-up (p value<0.00001). Conclusion: Telemedicine appointments for new referrals and follow-up patients with Rheumatological diagnoses has been a new development because of COVID-19 pandemic. Our analysis shows that most of our new RA, GCA, OA, and CA referrals are still being seen face-to-face but most follow-up appointments are telemedicine consultations. In most cases, clinicians felt that telemed-icine consultations avoided the need for a face-to-face appointment.