Publication Date
11-1-2024
Journal
Interactive Journal of Medical Research
DOI
10.2196/49065
PMID
39078399
PMCID
PMC11568399
PubMedCentral® Posted Date
11-1-2024
PubMedCentral® Full Text Version
Post-print
Published Open-Access
yes
Keywords
lupus, systemic lupus erythematosus, telemedicine, COVID-19, access to care, autoimmune disease, no-show, socioeconomic status, adherence, laboratory test, management
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.
Included in
Biochemistry, Biophysics, and Structural Biology Commons, Clinical Epidemiology Commons, COVID-19 Commons, Medical Sciences Commons, Medical Specialties Commons, Telemedicine Commons
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