Most Patients with PsA Satisfied with Virtual Care During COVID-19

Results of an online survey showed the prevalence of COVID-19 was low among patients with psoriatic arthritis (PsA) and participants were generally satisfied with their care during the pandemic, according to a study published in The Journal of Rheumatology.¹ Further, most patients would continue using virtual care for the duration of the pandemic.

Ashish J Mathew, MD, PhD

Credit: APLAR Congress

The COVID-19 pandemic generated a significant increase in telehealth visits. This in turn created a need for more real-world data on whether virtual care is an acceptable alternative to in-person care for patients with PsA. Studies such as this can aid in developing and implementing patient-informed virtual care to maintain positive relationships between clinicians and patients and ultimately reduce poor outcomes.²

“Immune-mediated inflammatory diseases (IMIDs), such as PsA, and their medications were investigated early in the pandemic to determine if they impacted COVID-19 infection risk and severity,” wrote Ashish J Mathew, MD, PhD, associated with the Psoriatic Arthritis Program at the University Healthy Network, University of Toronto, Canada, and colleagues. “Through a large cross-sectional case-reporting registry, the COVID-19 GlobalRheumatology Alliance demonstrated that patients with rheumatic disease tend to have similar or only slightly poorer COVID-19 outcomes compared to non-rheumatic disease populations.”

To evaluate the prevalence of COVID-19 infection among this patient population, assess the patient’s perspective of risk of infection, and determine the standard of virtual care offered in the early phases of the pandemic, investigators submitted an online survey to patients between June and September 2021. Originally, 600 patients were emailed, 378 did not respond, and 41 provided consent but did not complete the survey. In total, 79% (n = 152/192) of patients completed the survey.

The mean age of participants was 58 years, mean disease duration was 19 years, and 57% were men. The mean patient-reported symptom severity was 4.1 for joint, 3.2 for skin, and 3.7 overall. Most (74%, n = 86) patients would accept the impact of their PsA over the past for the next few months.

Of the 70 patients tested for COVID-19, 4 tested positive. Of these patients, all were admitted to the hospital and 2 required oxygen. Almost all (99%, n = 151) patients received ≥1 vaccine dose and 39% (n = 59) believed medications to treat their rheumatic disease increased their risk of acquiring COVID-19. Of the 130 who participated in a telemedicine assessment, 83% were happy with the consultation. Additionally, most were willing to continue with virtual consultations until the pandemic resolved. On a 10-point scale, the average satisfaction level with pandemic care was 7.9.

Although the study was one of the few including the patient perspective among those with PsA, investigators noted certain limitations. These included the online distribution method and the dependence on email communication. Therefore, patients without access to email were inherently excluded. Additionally, many patients who were emailed did not respond. Further, the sample size was not large enough to accurately capture COVID-19 infection disease data. Lastly, the study was conducted prior to the Omicron and other variants emerged.

“This study provides updated data on patient perspectives following the release of initial scientific data on IMIDs and COVID-19 infection risk and severity. COVID-19 prevalence was low among our patients,” investigators concluded. “The prevalence of patient concerns surrounding the impact of IMIDs and targeted medications should continue to be explored for the risk of behaviors such as stopping medications.”

References

1. ^{Pirouzmand N, Pereira D, Sutton M, Mathew AJ, Chandran V, Gladman DD. Psoriatic Arthritis And Covid-19 - Patient Perspectives In A Large Psoriatic Arthritis Cohort [published online ahead of print, 2023 Sep 1]. J Rheumatol. 2023;jrheum.2022-1265. doi:10.3899/jrheum.2022-1265}
2. ^{Al-Abri R, Al-Balushi A. Patient satisfaction survey as a tool towards quality improvement. Oman Med J 2014;29:3-7}