@Article{info:doi/10.2196/49065,
author="Bruera, Sebastian
and Staggers, Kristen Andrews
and Suarez-Almazor, Maria Eugenia
and Agarwal, Sandeep Krishna",
title="Telemedicine for Patients With Systemic Lupus Erythematosus in a Publicly Funded Hospital System: Retrospective Study",
journal="Interact J Med Res",
year="2024",
month="Nov",
day="1",
volume="13",
pages="e49065",
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. ",
issn="1929-073X",
doi="10.2196/49065",
url="https://www.i-jmr.org/2024/1/e49065",
url="https://doi.org/10.2196/49065",
url="http://www.ncbi.nlm.nih.gov/pubmed/39078399"
}