Sebastian Bruera, Kristen Andrews Staggers, Maria Eugenia Suarez-Almazor, Sandeep Krishna Agarwal
{"title":"Telemedicine for Patients With Systemic Lupus Erythematosus in a Publicly Funded Hospital System: Retrospective Study.","authors":"Sebastian Bruera, Kristen Andrews Staggers, Maria Eugenia Suarez-Almazor, Sandeep Krishna Agarwal","doi":"10.2196/49065","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":51757,"journal":{"name":"Interactive Journal of Medical Research","volume":" ","pages":"e49065"},"PeriodicalIF":1.9000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11568399/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Interactive Journal of Medical Research","FirstCategoryId":"92","ListUrlMain":"https://doi.org/10.2196/49065","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
引用次数: 0
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.