Abstract
BackgroundInflammatory arthritis (IA) patients have been identified as at greater risk of severe illness from COVID-19. It is likely that lockdown restrictions (enforced by the UK government in response to the COVID-19 pandemic) and subsequent changes made to healthcare provision could impact patients’ abilities to effectively manage their condition. The aim of this study was to qualitatively explore the impact of COVID-19 on self-management behaviours and healthcare access for people with IA.MethodsSemi-structured interviews were conducted with 21 IA patients in June-July 2020, with nine follow-up interviews in November 2020. Interview schedules were developed with a Patient Research Partner and explored participants’ experiences of the COVID-19 pandemic. Interviews were conducted via telephone and analysed using inductive thematic analysis.ResultsParticipants were aged between 24 and 79 years (mean = 50.1, SD = 15.8), largely female (71%) and White British (86%). Four initial themes were identified: (1) Impact of COVID-19 on medication adherence, (2) Impact of COVID-19 on physical activity, (3) Impact of COVID-19 on diet, and (4) Impact of COVID-19 on healthcare access and delivery. Subthemes focused on positive and negative changes made to these areas, as well as behaviours which remained consistent. Follow-up interviews highlighted differences in participants’ experiences during the two lockdown periods.ConclusionCOVID-19 has affected patients’ abilities to manage their IA. Healthcare professionals need to recognise the ongoing impact of COVID-19 on patient self-management and healthcare access to ensure that adequate understanding and support is available to patients who may have inadequate disease control as a result.
Highlights
Inflammatory arthritis (IA) patients have been identified as at greater risk of severe illness from COVID19
The unprecedented nature of the COVID-19 pandemic provided a unique opportunity to explore how people living with IA are able to manage their condition whilst observing lockdown restrictions
In order to reduce disease activity, IA patients are often prescribed immunosuppressant disease-modifying anti-rheumatic drugs (DMARDs) [3], which may lead to medication nonadherence in people with rheumatic disease [4] due to attributing higher risk of contracting COVID-19
Summary
Inflammatory arthritis (IA) patients have been identified as at greater risk of severe illness from COVID19. It is likely that lockdown restrictions (enforced by the UK government in response to the COVID-19 pandemic) and subsequent changes made to healthcare provision could impact patients’ abilities to effectively manage their condition. The aim of this study was to qualitatively explore the impact of COVID-19 on self-management behaviours and healthcare access for people with IA. Inflammatory arthritis (IA) patients were identified as at greater risk of severe illness from COVID-19 and advised to follow strict ‘shielding’ guidelines. These guidelines encouraged patients to refrain from leaving their home, except for medical appointments, and to get food and medication delivered [2]. The pandemic has seen significant changes made to healthcare access and delivery as many face-to-face consultations were cancelled in favour of remote consultations [7]
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