Telemedicine for Patients With Systemic Lupus Erythematosus in a Publicly Funded Hospital System: Retrospective Study.

IF 1.9 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Interactive Journal of Medical Research Pub Date : 2024-11-01 DOI:10.2196/49065
Sebastian Bruera, Kristen Andrews Staggers, Maria Eugenia Suarez-Almazor, Sandeep Krishna Agarwal
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Abstract

Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that requires frequent clinic and laboratory visits. However, patients with SLE, particularly those who are underresourced, have unacceptably high rates of no-shows.

Objective: This study aims to determine no-show rates associated with telemedicine visits during the COVID-19 pandemic in comparison to no-show rates associated with contemporaneous and historic in-person visits.

Methods: We performed a retrospective cohort study in a publicly funded county hospital system in Houston, Texas. We identified a cohort of established patients with SLE by the International Classification of Diseases codes that were independently confirmed as SLE by a review of medical records. We identified patients who were seen from March to December in 2018, 2019, and 2020 (to reflect the height of the COVID-19 pandemic and account for seasonal changes in disease activity). Our primary outcome was the percentage of no-shows for rheumatology clinic appointments. Our secondary outcome was laboratory use adherence, which was defined as lupus-specific blood and urine studies conducted within 30 days of the scheduled appointment. Covariates included age, sex, race, ethnicity, and SLE-related prescription drugs.

Results: We included 156 patients with SLE in our analysis. Most were female (n=141, 90.4%), were Hispanic (n=75, 49.3%), and had a median age of 43 (range 19-80) years. In 2020, the no-show rate for telemedicine was 5.5% (10/182) compared to a no-show rate of 16.2% (31/191) for in-person visits (P=.002). After multivariable adjustment for covariates, the odds of no-show were lower for telemedicine visits (odds ratio 0.39, 95% CI 0.20-0.77). There were no differences in adherence to laboratory testing.

Conclusions: Telemedicine visits had decreased odds of no-shows without difference in laboratory testing adherence after adjustment for covariates. More research is needed to determine the clinical impact of telemedicine on patients with SLE.

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为公立医院系统中的系统性红斑狼疮患者提供远程医疗:一项回顾性研究。
背景:系统性红斑狼疮(SLE系统性红斑狼疮(SLE)是一种慢性自身免疫性疾病,需要频繁就诊和化验。然而,系统性红斑狼疮患者,尤其是资源不足的患者,不去就诊的比例高得令人难以接受:本研究的目的是确定在 COVID-19 大流行期间与远程医疗就诊相关的未就诊率,并与当时和历史上的面对面就诊相关的未就诊率进行比较:我们在得克萨斯州休斯敦市的一家公立医院系统进行了一项回顾性队列研究。我们根据国际诊断分类(ICD)代码确定了一批已确诊的系统性红斑狼疮患者,这些患者通过查看病历被独立确认为系统性红斑狼疮。我们确定了 2018 年、2019 年和 2020 年 3 月至 12 月期间就诊的患者(以反映 COVID-19 大流行的高峰期并考虑疾病活动的季节性变化)。我们的主要结果是风湿病门诊预约未出现的百分比。我们的次要结果是坚持使用实验室,即在预约后 30 天内进行狼疮特异性血液和尿液检查。协变量包括年龄、性别、种族、民族和系统性红斑狼疮相关处方药:我们分析了 156 名系统性红斑狼疮患者。大多数患者为女性(90.4%)、西班牙裔(49.3%),年龄中位数为 43 岁。2020 年,远程医疗的缺席率为 5.5%,而亲自就诊的缺席率为 16.2%(P=0.002)。在对协变量进行多变量调整后,远程医疗就诊的缺席几率更低(OR 0.39,95% CI 0.20-0.77)。在坚持实验室检测方面没有差异:结论:经协变量调整后,远程医疗就诊的缺席几率降低,但实验室检测的依从性没有差异。要确定远程医疗对系统性红斑狼疮患者的临床影响,还需要进行更多的研究:
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来源期刊
Interactive Journal of Medical Research
Interactive Journal of Medical Research MEDICINE, RESEARCH & EXPERIMENTAL-
自引率
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发文量
45
审稿时长
12 weeks
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