Date: Monday, November 8, 2021
Session Type: Abstract Session
Session Time: 4:45PM-5:00PM
Background/Purpose: Telemedicine (TM) has been widely advocated and used to follow up patients with rheumatic diseases during the COVID-19 outbreak. However, there is no evidence supporting its use in systemic lupus erythematosus. We aimed to evaluate the short-term patient satisfaction, compliance, disease control and infection risk of TM compared with standard in-person follow-up (FU) for patients with lupus nephritis (LN) during the pandemic.
Methods: This was a single-center open-label randomized controlled study. Consecutive patients followed at the LN clinic were randomized to either TM or standard FU (SF) group in a 1:1 ratio. Patients in the TM group received FU via videoconferencing. SF group patients continued conventional in-person outpatient care. The 6-month data were compared and presented.
Results: From June to December 2020, 122 patients were randomized (TM: 60, SF: 62) and had at least 2 FUs. There were no baseline differences, including SLEDAI-2k and proportion of patients in lupus low disease activity state (LLDAS), between the 2 groups except a higher physician global assessment score (PGA) in the TM group (table). After a mean FU of 19.8±4.5 weeks, the overall patient satisfaction score was higher in the TM group with a significantly shorter waiting time from entering the clinic waiting room (virtual or real) to seeing a rheumatologist (figure). More patients in the TM group had hospitalization (15/60, 25.0% vs 7/62, 11.3%; p=0.049) with higher baseline PGA (OR=1.15, 95% CI 1.07-1.23) being the independent predictor. The proportions of patients remained in LLDAS were similar in the 2 groups (TM: 75.0% vs SF: 74.2%, p=0.919). None of the patients had COVID-19.
Conclusion: TM FU resulted in better patient satisfaction and similar short-term disease control in patients with LN compared to standard care. However, it was associated with more hospitalizations and might need to be complemented by in-person visits especially in patients with higher PGA.
Figure A. Mean waiting time between entering the clinic waiting room (virtual or real) and seeing a rheumatologist. TM = Telemedicine, SF = Standard follow-up. B. Satisfaction scores of patients who used TM) compared to SF. Response is shown as percentage with positive responses on the right. The neutral category was removed when calculating percentages.
To cite this abstract in AMA style:SO h, Chow E, Cheng I, Lau X, Li T, Szeto C, Tam L. Use of Telemedicine for Follow-up of Lupus Nephritis in the COVID-19 Outbreak: The 6-month Results of a Randomized Controlled Trial [abstract]. Arthritis Rheumatol. 2021; 73 (suppl 9). https://acrabstracts.org/abstract/use-of-telemedicine-for-follow-up-of-lupus-nephritis-in-the-covid-19-outbreak-the-6-month-results-of-a-randomized-controlled-trial/. Accessed September 25, 2022.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/use-of-telemedicine-for-follow-up-of-lupus-nephritis-in-the-covid-19-outbreak-the-6-month-results-of-a-randomized-controlled-trial/