AB0921-PARE PRACTICES AND BEHAVIORS DURING THE COVID-19 PANDEMIC IN PATIENTS WHO PARTIALLY ATTEND TO AN EDUCATIONAL PROGRAM ON RHEUMATOID ARTHRITIS. A CROSS-SECTIONAL SURVEY

Abstract

Background: The new coronavirus disease has become a public health emergency that has not been seen for generations. Covid-19 disease leads to an extreme immune activation and cytokine response and constitutes a big risk and a challenge for patients with inflammatory conditions such as rheumatoid arthritis (RA). During the Covid-19 pandemic, rheumatologists and health-care professionals have faced many challenges to provide an adequate follow-up and treatment to RA patients; one of them, has been the establishment of lockdown for populations older than 60 years and the limitation of having face-to-face consultations, moving us to telemedicine activities. On the other hand, in our center an education program for patients with RA had been established in the second semester of 2019, which due to the epidemiological risk control measures, it was necessary to interrupt when we only had 5-6 months of a project that was planned for 2 years; it was mandatory to pause it and implement virtual education alternatives; this educational program for RA patients was also moved to virtual mode later. Objectives: To describe possible changes in the practices and behaviors of patients with rheumatoid arthritis (RA) during the lockdown that started in March 2020 in Colombia due to the Covid-19 pandemic, who previously partially attended to an educational program on RA. Methods: We included patients who attended previously a face-to-face educational program, that aims to teach and empower patients in all aspects related to RA. After the lockdown, the educational program had to stop abruptly while an online strategy was developed later; meanwhile the patients did not have any educational activity for 3-4 months. For this study, patients answered to a telephonic survey in July 2020; the survey included questions about their practices related to the Covid-19 pandemic, SARS-Cov-2 symptoms, adherence to rheumatoid arthritis treatment, virtual rheumatology consultations compliance and, the influence of news on their adherence. Results: A total of 260 patients took part in the survey; mean age of the respondents was 60 years IQR (54-66), 93% were female. In July 2020 88% of patients had accessed a telemedicine-based and 12% a face-to-face rheumatology consultation; only 3.5% of patients reported having been less adherent to pharmacological therapy due to information received through media or social networks. Regarding the prevention measures taken during the pandemic, 98% reported to have stayed in their houses since the lockdown was stablished in Colombia, and have implemented or increased hand washing from one or none to more than three times per day. Also 8% of respondents lived with people who were at bigger risk of having SARS-CoV-2 (i.e. health care professionals, workers at public transportation, and supermarkets among others), the main measurement taken was to be completely separate from the person at risk to avoid contagion and maintaining hygiene measures and physical distancing (Fig 1). Only one patient was positive for SARS-CoV-2, due to a possible contagion from a relative at home and reported only flu-like symptoms without any complications. Patients highlighted the necessity to return to the educational on RA program agreeing to attend to an online modality. Patients highlighted the need for educational sessions focused on the relationship between rheumatoid arthritis, its treatment, and Covid-19. Conclusion: An educational on RA program shows to be helpful tool to maintain high adherence rates to the RA treatment despite of the new challenges associated to the pandemic and despite being incomplete due to lack of time; patient-centered education programs should continue to address the patient's concerns and beliefs about their disease and the Covid-19 issues.