medwireNews: Better access to treatment and a dedicated telemedicine platform are among the suggestions made to remedy the negative impact the COVID-19 pandemic has had on rheumatology practice in Arab countries, following results from a recent survey.
Nelly Ziadé (Saint-Joseph University, Beirut, Lebanon) and colleagues say that their study, based on a 21-item online survey completed by 858 rheumatologists from 15 Arab countries, “highlights the deleterious consequences of the COVID-19 pandemic on the rheumatology practice by compromising the access to clinical care and to fundamental drugs,” which they believe “may jeopardize the control of chronic rheumatic diseases and the long-term prognosis.”
Based on the survey responses collected throughout May 2020, the researchers estimate that the COVID-19 pandemic was associated with a 69% decrease in hospitalizations, 65% decrease in outpatient clinics, and 56% decrease in visits to infusion centers. As a result of the reduction in access to in-person care, there was a rise in the use of telemedicine, accessed in 70% of cases, mostly in the form of telephone or email contact.
Ziadé and team note that telemedicine is not well established in Arab countries and that “[t]he main obstacles include the absence of a legal telemedicine framework and the reluctance of patients to renounce their privileged physician-patient direct communication.”
The study’s steering committee – a group of rheumatologists from the Arab League of Associations for Rheumatology – developed the survey with a section of open-ended questions to find areas of unmet need, one of which was the development of a telemedicine platform.
In light of these responses, “[s]uggestions were developed to improve practice and include developing unified local guidelines for the rheumatologists and the patients,” the researchers explain.
The steering committee’s recommendations included “establishing a reliable telemedicine platform that will help to rationalize human resources, reduce infection risk, and ensure the proper continuity of rheumatology care,” report Ziadé et al in Clinical Rheumatology.
Access to drugs, specifically biologics and hydroxychloroquine, was another common concern among rheumatologists, with 47.0% reporting a shortage of hydroxychloroquine and a further 24.2% reporting a difficulty in accessing the treatment.
The recommendation here would be “working with heath authorities to guarantee the availability of drugs for patients,” according to the committee.
The need for patient education and continuous medical education for physicians was also underlined by the results of the survey, leading the committee to propose the development of “unified guidance” for rheumatology patients and rheumatologists during the pandemic and transition to deconfinement, as well as the promotion of patient and rheumatologist education.
The study authors note: “Although international recommendations are published, having local guidance based on the Arab region’s specific unmet needs is of utmost importance in the current pandemic.”
medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2020 Springer Healthcare Ltd, part of the Springer Nature Group
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Clin Rheumatol 2020; doi:10.1007/s10067-020-05428-2