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The impact of COVID-19 pandemic on rheumatology practice: a cross-sectional multinational study
Nelly Ziadé1, Ihsane Hmamouchi2, Lina El Kibbi3
1Hotel-Dieu de France Hospital, Saint-Joseph University, 6th floor, Tour des Consultations Externes, Alfred Naccache blvd. Achrafieh, Beirut, Lebanon. nellziade@yahoo.fr.
Insights
The COVID-19 pandemic significantly disrupted rheumatology care, causing major decreases in hospitalizations and outpatient visits. Improving drug access and telemedicine platforms are crucial for better rheumatic disease management.
Area of Science:
- Rheumatology
- Infectious Diseases
- Public Health
Background:
- The COVID-19 pandemic presented unprecedented challenges to healthcare systems globally.
- Rheumatology practices faced significant disruptions in patient care and access to essential treatments.
Purpose of the Study:
- To assess the multifaceted impact of the COVID-19 pandemic on rheumatology practice.
- To identify unmet needs and propose recommendations for improving rheumatology care delivery.
Main Methods:
- A cross-sectional web survey was conducted among rheumatologists in the Arab League of Associations for Rheumatology (ArLAR).
- The survey collected data on changes in outpatient visits, hospitalizations, and drug availability.
- Statistical analyses were performed to identify predictors of pandemic impact.
Main Results:
- Significant reductions were observed in hospitalizations (69%), outpatient clinics (65%), and infusion centers (56%).
- A hydroxychloroquine shortage affected 47% of practices, and telemedicine was primarily phone/email-based and poorly reimbursed.
- Rheumatologists reported unmet needs including drug access and telemedicine platforms.
Conclusions:
- The COVID-19 pandemic negatively impacted rheumatology practice, potentially compromising rheumatic disease control.
- Enhanced access to essential medications and robust telemedicine platforms are recommended to mitigate these effects.
Objective:
To evaluate the impact of the coronavirus disease 2019 (COVID-19) pandemic on rheumatology practice.
Method:
A cross-sectional web survey was designed by the members of the Arab League of Associations for Rheumatology (ArLAR), validated by its scientific committee and disseminated through e-mail and social media. It included close-ended questions about the impact of the pandemic on the rheumatology activities, including outpatient visits and hospitalizations (in percentage, 100% corresponds to complete suspension) and open-ended questions about unmet needs. Univariate and multivariable logistic regression analyses were used to evaluate the predictors of impact. Suggestions were developed to improve the practice.
Results:
A total of 858 rheumatologists were included in the analysis (27.3% of registered in ArLAR), 37% were 35-44 years old, 60% were females, and 48% worked in the private sector. The impact of COVID-19 was a decrease of 69% in hospitalizations, 65% in outpatient clinic, 56% in infusion centers, and 43% in income. It was associated with the region (highest in the Gulf), use of telemedicine, impact on income and practice sector (lowest in private). There was a hydroxychloroquine shortage in 47%. Telemedicine was mostly based on traditional telephone contacts and e-mails and reimbursed in 12%. Fifteen rheumatologists (1.8%) were infected and 156 cases of COVID-19 were reported among patients. The top-cited unmet needs in rheumatology practice were access to drugs and a telemedicine platform.
Conclusions:
The negative impact of the COVID-19 pandemic on rheumatology practice may compromise rheumatic diseases control. Better access to drugs and providing telemedicine platforms are recommended to improve the practice. Key Points • The COVID-19 pandemic had a significant negative impact on the rheumatology practice, including access to outpatient clinic, hospitalization, and to anchor drugs. • The compromised access to rheumatology care may jeopardize the control of chronic rheumatic diseases and the long-term prognosis. • Better access to drugs and providing telemedicine platforms are strongly recommended.
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