Lessons from experiences of accessing healthcare during the pandemic for remobilising rheumatology services: a national mixed methods study

Lakrista Morton, Kevin Stelfox, Marcus Beasley, Gareth Jones, Gary Macfarlane, Peter Murchie, William John Paton, Rosemary Hollick* (Corresponding Author)

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: To understand the impact of the COVID-19 pandemic on access to healthcare services for patients with inflammatory and non-inflammatory MSK conditions.
Methods: Three established cohorts which included individuals with axial spondyloarthritis, psoriatic arthritis, and musculoskeletal pain completed a questionnaire between July and December 2020. In parallel, a subset of individuals participated in semi-structured interviews.
Results: 1054 people (45% female, median age 59 years) were included in the quantitative analyses.
Qualitative data included 447 free-text questionnaire responses and 23 interviews. 57% respondents had tried to access care since the start of UK national lockdown. Over a quarter reported being unable to book any type of healthcare appointment. GP appointments were less likely to be delayed
or cancelled compared to hospital appointments. Younger age, unemployment/health-related retirement, DMARD therapy, anxiety or depression and being extremely clinically vulnerable was associated with a greater likelihood of attempting to access healthcare. People not in work, those
reporting anxiety or depression and poorer quality of life were less likely to be satisfied with remotely-delivered healthcare. Participants valued clear, timely and transparent care pathways across primary care and specialist services. Whilst remote consultations were convenient for some, in-person appointments enabled physical assessment and facilitated development and maintenance
of clinical relationships with care providers.
Conclusions: We have identified patient factors that predict access to and satisfaction with care, and aspects of care that patients value. This is important to inform remobilisation of rheumatology services to better meet the needs of patients.
Original languageEnglish
Article numberrkac013
Number of pages15
JournalRheumatology Advances in Practice
Volume6
Issue number1
Early online date16 Feb 2022
DOIs
Publication statusPublished - 23 Mar 2022

Keywords

  • COVID-19
  • axial spondyloarthritis
  • psoriatic arthritis
  • pain
  • healthcare access
  • healthcare behaviour

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