scholarly journals AB0907-HPR UNEXPECTED DIFFERENCE IN ACCEPTANCE OF TELECONSULTATION BETWEEN PATIENTS WITH LUPUS AND RHEUMATOID ARTHRITIS WHO UNDERWENT TO A DEVELOPED AND IMPLEMENTED TELEMEDICINE INNOVATIVE PROGRAM AFTER THE DECLARATION OF QUARANTINE DUE TO THE COVID-19 PANDEMIC IN COLOMBIA

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1475.3-1476
Author(s):  
S. M. Hernández-Zambrano ◽  
R. A. Castiblanco-Montañez ◽  
J. Chavez-Chavez ◽  
D. P. Rivera-Triana ◽  
A. Aza ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Categorical Variables ◽  
P Value ◽  
Systemic Lupus ◽  
Telemedicine Service ◽  
Face To Face ◽  
The Face

Background:The Covid-19 pandemic has generated restrictions in the mobility of people, affecting the face-to-face care of patients with chronic diseases, including autoimmune. The health emergency has created the need to establish follow-up alternatives, giving rise to telemedicine.Objectives:To evaluate the level of attendance to teleconsultation and the face-to-face usual care in patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) who underwent to a developed innovative telemedicine program after the declaration of quarantine due to the Covid-19 pandemic.Methods:The present cross-sectional descriptive study reports retrospective data collected from patients with RA and SLE from March to June, 2020;. Since the beginning of March 2020 when Covid-19 was declared in Colombia as a health emergency establishing specific standards for outpatient care, our center has made the necessary legal and technical adjustments to develop an innovative telemedicine service to prevent the epidemiological risk. To all contacted patients were offered the option of teleconsultation or face-to-face consultation; a standardized protocol was set with clinimetry measures evaluated in both groups. Continuous variables were described using mean and standard deviation, and categorical variables were described using numbers and percentages. We performed chi-square tests of independence to determine differences between teleconsulting and conventional face-to-face consultation.Results:A total of 5745 RA patients were followed-up, 5292 (92.1%) by teleconsulting and 453 (7.9%) by conventional face-to-face consultation; among the group of SLE patients, a total of 646 were assessed, of which there were 386 (60%) by teleconsultation and 260 (40%) by face-to-face consultation; this highlights an important difference in the level of acceptance of the teleconsultation between patients with RA and SLE, being much lower in patients with SLE (p value< 0.0001). Regarding gender differences, in men, there were 33 (12.7%) SLE and 89 (19.6%) RA face-to-face consultations, while in women there were 227 (87.3%) SLE and 364 (80.4%) RA in a face-to-face consultation. Regarding patients who were attended through telemedicine, 45 (11.7%) SLE and 966 (18.3%) RA were men, while 341 (88.3%) SLE and 4326 (81.7%) RA were women; that means, in the RA cohort, a greater number of men prefer the face-to-face consultation than in the SLE cohort (p value< 0.0185). 10 RA patients were diagnosed with the Covid-19 in teleconsultation; in all cases, close contact with infected relatives was verified as the probable cause.Table 1.Differences by gender in the level of teleconsultation acceptance and face-to-face assistance in patients with SLE and RARA PatientsGenderTeleconsulting (%a)Face-to-face consultation (%a)Male105596691,57%898,43%Female4690432692,23%3647,77%SLE PatientsGenderTeleconsulting (%a)Face-to-face consultation (%a)Male784557,69%3342,31%Female56834160,03%22739,97%a Total percentage of patients by gender. RA: Rheumatoid arthritis; SLE: Systemic lupus erythematosus.Conclusion:Telemedicine may provide a viable option for the follow-up of patients with rheumatological diseases even beyond the pandemic. But unexpectedly, data showed an important difference in the acceptance of teleconsultation between patients with RA and SLE, being much higher in older and/or male patients with RA compared to patients with SLE; however, further studies are needed to support this conclusion.Disclosure of Interests:None declared

AB0246 FACTORS ASSOCIATED WITH THE TIME OF PRESENTATION OF CARDIOVASCULAR EVENTS IN A COHORT OF COLOMBIAN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1423-1424
Author(s):  
S. Herrera ◽  
J. C. Diaz-Coronado ◽  
D. Rojas-Gualdrón ◽  
L. Betancur-Vasquez ◽  
D. Gonzalez-Hurtado ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Cardiovascular Risk ◽  
Lupus Erythematosus ◽  
Renal Involvement ◽  
P Value ◽  
Systemic Lupus ◽  
P Values ◽  
Interval Censored ◽  
Age And Sex

Background:Systemic lupus erythematosus is a systemic disease characterized by a compromise of vital organs. The autoimmune activity has been linked to accelerated endothelial damage and increased cardiovascular risk and its outcomes such as heart attack, stroke, and peripheral arterial disease(1). Patients with Lupic nephritis have been characterized by requiring aggressive immunosuppressive therapies apart from prolonged and progressive use of corticosteroids, what you have shown can accelerate these outcomes(2). Other factors such as secondary arterial hypertension, dyslipidemia among others are factors to consider (3).Objectives:To analyze clinical and immunological characteristics associated with time to severe renal involvement in patients with Systemic Lupus Erythematous in a Colombian cohort followed for one year, between January 2015 and December 2018.Methods:Retrospective follow-up study based on clinical records of patients with SLE diagnosis that fulfilled either 1987 American College of Rheumatology Classification Criteria for SLE or 2011 Systemic Lupus International Collaborating Clinics (SLICC) classification criteria for SLE. Patients with cardiovascular disease outcomes such as angina, acute myocardial infarction, stroke, transient cerebral ischemia and chronic arterial occlusive disease were included. Patients who did not have at least two follow-up measurements or had structural heart disease, valvulopathies, arrhythmias, myocarditis, pericarditis were excluded. The main outcome was defined as the time from diagnosis to cardiovascular diseases.Clinical and immunological characteristics were analyzed. Descriptive statistical analyses of participant data during the first evaluation are reported as frequencies and percentages for categorical variables, and as medians and interquartile ranges for quantitative variables. Age and sex adjusted survival functions and Hazard Ratios (HR) with 95% confidence intervals and p-values were estimated using parametric Weibull models for interval-censored data. P values < 0.05 were considered statistically significantResults:547 patients were analyzed: 29 were left-censored as they presented renal involvement at entry, 22 were interval censored as outcome occurred between study visits, and 496 were right-censored as involvement was not registered during follow-up. 528 (96.5%) patients were female, median age at entry was 46 (IQR = 23) and median age to diagnosis was 29.4 (IQR = 20.9). Statistically significant age and sex adjusted variables were High Blood Pressure (HBP) HR = 2.0 (95%CI 1.1-3.6; p-value <0.018) and cumulative prednisolone dose (>10 gr vs <2 gr) HR = 2.4 (95%CI 1. 1-5.1; p-value = 0.023). Figure 1 shows the age and sex adjusted survival function for HBPConclusion:HBP and cumulative steroid doses accelerate the onset of cardiovascular diseases in patients with lupus more than two times. Maintaining blood pressure in goals and performing early clearance of glucocorticoids could improve outcomes in these patients who are already considered a high cardiovascular riskReferences:[1]Hans-Joachim Anders, Ramesh Saxena, Ming-Hui Zhao. Lupus Nephritis. Nat Rev Dis Primers. 2020 Jan 23;6(1):7.[2]Shanthini Kasturi, Lisa R Sammaritano. Corticosteroids in Lupus. Rheum Dis Clin North Am, 42 (1), 47-62, viii[3]César Magro-Checa, Juan Salvatierra, José Luis Rosales-Alexander, et al. Cardiovascular risk in systemic lupus erythematosus: implicated factors and assessment methods. Semin Fund Esp Reumatol. 2012;13(3):95–102Disclosure of Interests:Sebastian Herrera Speakers bureau: academic conference, Juan camilo Diaz-Coronado: None declared, Diego Rojas-Gualdrón: None declared, Laura Betancur-Vasquez: None declared, Daniel Gonzalez-Hurtado: None declared, Juanita Gonzalez-Arango: None declared, laura Uribe-Arango: None declared, Maria Fernanda Saavedra Chacón: None declared, Jorge Lacouture-Fierro: None declared, Santiago Monsalve: None declared, Sebastian Guerra-Zarama: None declared, Juan david Serna: None declared, Julian Barbosa: None declared, Deicy Hernandez-Parra: None declared, Ana Sierra: None declared, Ricardo Pineda.Tamayo: None declared

scholarly journals Awareness of Systemic Lupus Erythematosus among Primary Health Care Patients in Riyadh, Saudi Arabia

2018 ◽  
Vol 6 (12) ◽  
pp. 2386-2392 ◽  
Author(s):  
Kholoud A. Bin Haikel ◽  
Bader Al Tulaihi
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Health Care ◽  
Primary Health Care ◽  
Lupus Erythematosus ◽  
Categorical Variables ◽  
P Value ◽  
Systemic Lupus ◽  
Male And Female ◽  
Primary Health ◽  
Significant Difference

AIM: To measure the level of Systemic Lupus Erythematosus awareness among visitors in PHC at KAMC and to explores the factors which influence the Systemic Lupus Erythematosus awareness. METHODS: The study was a cross-sectional study conducted between February and September 2018 in four primary health care centers belong to King Abdulaziz Medical City. The study participants were male and female adult visitors to the centers` age from 18 to 60 years of age. The sample size was 400 participants. The participants were enrolled via a random convenience sampling method. Study data was collected using a self-administered questionnaire. Analytic statistics were done using the Chi-square (c2) test for associations and/or the difference between two categorical variables. A P-value ≤ 0.05 was considered statistically significant. RESULTS: The awareness about Systemic Lupus Erythematosus among male and female was not statistically significant as (P = 0.304), but there was a statistically significant difference according to education level. Visitors with high school education are aware of Systemic Lupus Erythematosus than those with a lower level of education (Primary & Middle school) who are not aware of the Systemic Lupus Erythematosus by (P = 0.023). CONCLUSION: The study shows that this survey is valuable and beneficial to the community as it helps people to assess their knowledge about Systemic Lupus Erythematosus and become aware of this disease, as well as awareness of Systemic Lupus Erythematosus should be promoted among the community.

scholarly journals POS0719 ADVERSE OUTCOMES AND REHOSPITALIZATION AFTER DELIVERY AMONG WOMEN WITH SYSTEMIC LUPUS ERYTHEMATOSUS OR RHEUMATOID ARTHRITIS AND THEIR INFANTS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 609.1-609
Author(s):  
J. Sabo ◽  
N. Singh ◽  
D. A. Crane ◽  
D. R. Doody ◽  
M. A. Schiff ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systemic Lupus Erythematosus ◽  
Hospital Discharge ◽  
Birth Outcomes ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Lupus Erythematosus ◽  
Adverse Outcomes ◽  
Systemic Lupus ◽  
Cesarean Deliveries

Background:Women with rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE) have greater risk of adverse obstetric and birth outcomes than women without these conditions. Infant outcomes are less well-studied. It is unknown whether re-hospitalization after delivery occurs more often for affected mothers and their infants.Objectives:We compared obstetric outcomes among women with and without RA or SLE, and birth outcomes among their infants. Maternal and infant rehospitalizations <2 years of delivery were also compared.Methods:This population-based cohort study used linked birth-hospital discharge data from Washington State for 1987-2014. International Classification of Disease 9th revision (ICD9) codes identified all women with RA (ICD9 714.X, 725.X) and SLE (ICD9 710, 710.0, 710.1) in the hospital discharge record at delivery, and a 10:1 comparison group of women without these codes. Analyses were restricted to singleton live births (1,223 RA; 1,354 SLE). Poisson regression with robust standard errors estimated relative risks (RR) and 95% confidence intervals (CI) for selected outcomes, accounting for delivery year, maternal age, and parity.Results:Many adverse outcomes were more common among RA and SLE cases than among comparison women. Preeclampsia occurred more often during pregnancies of women with RA (RR 1.42, 95% CI 1.17-1.71) or SLE (RR 2.33, 95% CI 2.01-2.70), as did preterm rupture of membranes (PROM, RR 2.85, 95% CI 2.20-3.72 for RA; RR 3.28, 95% CI 2.54-4.23 for SLE). Cesarean deliveries were more common among nulliparous women in both groups (RR 1.32, 95% CI 1.18-1.48 for both conditions). Infants of women with RA or SLE were more likely to weigh <2500 g (RR 2.08, 95% CI 1.72-2.52 for RA; RR 4.88, 95% CI 4.27-5.58 for SLE), be small for gestational age (RR 1.25, 95% CI 1.07-2.50; RR 2.30; 2.04-2.59, respectively), delivered at <32 weeks gestation (RR 1.83, 95% CI 1.13-2.97; RR 5.13, 95% CI 3.75-7.01, respectively), and require neonatal intensive care unit admission (NICU, RR 1.89, 95% CI 1.56-2.30; RR 2.71, 95% CI 2.25-3.28, respectively). Infants of women with SLE were more likely to have a malformation (RR 1.46, 95% CI 1.21-1.75) or die within 2 years (RR 2.11, 95% CI 1.21-3.67). Rehospitalization levels among both women with RA (RR 2.22; 1.62-3.04) and SLE (RR 2.78, 95% CI 2.15-3.59) were greatest <6 months of delivery and declined over time. Infants of women with SLE had increased rehospitalization <6 months (RR 1.64, 95% CI 1.36-1.98).Conclusion:Consistent with prior literature, we found women with RA or SLE experienced many adverse outcomes. In our data, these included preeclampsia, PROM, and cesarean deliveries, with increased risks more notable among women with SLE. Infants of women with either condition were more likely to weigh <2500g, be <32 weeks gestation, small for gestational age, and require NICU admission than infants of comparison women. Only infants of women with SLE had increased malformations. Maternal rehospitalization after delivery was more common in both groups; most marked at <6 months. Infant rehospitalizations were increased in both cohorts to a lesser extent. Close follow-up during this time period is crucial to minimize adverse outcomes.Disclosure of Interests:Julianna Sabo: None declared, Namrata Singh: None declared, Deborah A. Crane: None declared, David R. Doody: None declared, Melissa A. Schiff: None declared, Beth A. Mueller Shareholder of: Household owns shares in AstraZeneca

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