Evaluation of a non-face to face multidisciplinary health care model in a population with rheumatoid arthritis vulnerable to covid-19 in a health emergency situation

Abstract

Objectives: The COVID-19 pandemic has impacted everyday practice pattern of health care in rheumatoid arthritis (RA) patients. The objective was to evaluate the implementation of a tele-consultation program in an adult population with RA Methods: Analytical observational study longitudinal cohort (Clinical trials NCT04768413) that evaluated the effectiveness of a tele consultation model compared with a face-to-face consultation model in adult RA patients. Patients were followed 12 weeks (Jul-Oct 2020) at an RA center of excellence in Colombia. Simple random sampling was done. Two groups were included: Group A, patients who were cared for by tele-consultation care and Group B, thosewho wished to continue with the usual face-to-face consultation. Data regarding activity of disease (Week 0,6,12) [Patient Activity Scale (PAS) in both groups and DAS28 in group B], and Quality of life [EQ-5D-3L], disability [Health Assessment Questionnaire (HAQ)], therapeutic adherence [Morisky-Green Adherence Scale (MGLS)] and self-care capacity [Appraisal of Self-care Agency Scale -Revised (ASA-R)] were evaluated (weeks 0-12). Outcomes regarding COVID-19 were evaluated. Bivariate analysis was done (StataV-13;P-value remote>presential (p = 0,0001);the same result was documented in the group presential>remote>presential, with an increase in adherence (p = 0,033). 7 patients developed COVID-19 (one patient hospitalized/group A and one patient died/mixed model) Conclusion: In the tele consultation model patients remained adherent to their RA treatment, without major differences compared to the face-to-face model. It is important to know these results due to the impact they have, given the changes that will follow in the care of RA patients due the current pandemic. Studies with a longer follow-up period are required to corroborate these results.