Impact of teleconsultation on subsequent disease activity and flares in patients with systemic lupus erythematosus

Objectives: Despite the widespread adoption of teleconsultations amid the COVID-19 pandemic, their safety in SLE patients has not been evaluated. Here, we examined subsequent disease activity and flares among SLE patients who received teleconsultation vs in-person consultation. To discern difference...

Full description

Saved in:
Bibliographic Details
Main Authors: Au Eong, Jonathan T. W., Lateef, Aisha, Liang, Shen, Lim, Sandy H. H., Tay, Sen Hee, Mak, Anselm, Cho, Jiacai
Other Authors: Lee Kong Chian School of Medicine (LKCMedicine)
Format: Article
Language:English
Published: 2022
Subjects:
Online Access:https://hdl.handle.net/10356/162794
Tags: Add Tag
No Tags, Be the first to tag this record!
Institution: Nanyang Technological University
Language: English
id sg-ntu-dr.10356-162794
record_format dspace
spelling sg-ntu-dr.10356-1627942022-11-09T01:58:59Z Impact of teleconsultation on subsequent disease activity and flares in patients with systemic lupus erythematosus Au Eong, Jonathan T. W. Lateef, Aisha Liang, Shen Lim, Sandy H. H. Tay, Sen Hee Mak, Anselm Cho, Jiacai Lee Kong Chian School of Medicine (LKCMedicine) Science::Medicine Systemic Lupus Erythematosus Telemedicine Objectives: Despite the widespread adoption of teleconsultations amid the COVID-19 pandemic, their safety in SLE patients has not been evaluated. Here, we examined subsequent disease activity and flares among SLE patients who received teleconsultation vs in-person consultation. To discern differences in physicians' prescription behaviour during both forms of consultations, we compared corticosteroid dose adjustments. Methods: We studied adult SLE patients who were seen between 1 February 2020 and 1 February 2021. At each patient-visit, rheumatologists utilized phone/video teleconsultation or physical consultation at their discretion. Disease activity was assessed with SLE Disease Activity Index 2000 (SLEDAI-2K) and flares were defined by the SELENA-SLEDAI Flare Index (SFI). We derived a propensity score for patients who were chosen for physical consultation. Multivariable generalized estimation equations were used to analyse SLEDAI-2k and flare at the next visit, adjusted for the propensity score. Results: A total of 435 visits were recorded, of which 343 (78.9%) were physical visits and 92 (21.1%) were teleconsultations. The modality of consultation did not predict flare [OR for physical consultation (95% CI) 0.42 (0.04, 5.04), P =0.49] or SLEDAI-2k at the next visit [estimate of coefficient for physical consultation (95% CI) -0.19 (-0.80, 0.43), P =0.55]. Adjustments of prednisolone dosages were comparable between the two forms of visits [OR for physical consultation (95% CI) 1.34 (0.77, 2.34), P =0.30]. Conclusion: SLE disease activity and flares at the subsequent visit were similar between teleconsultations and physical consultations. Medication prescription behaviour, determined using adjustment in corticosteroid dosages, was not different between the two forms of visits. 2022-11-09T01:58:59Z 2022-11-09T01:58:59Z 2022 Journal Article Au Eong, J. T. W., Lateef, A., Liang, S., Lim, S. H. H., Tay, S. H., Mak, A. & Cho, J. (2022). Impact of teleconsultation on subsequent disease activity and flares in patients with systemic lupus erythematosus. Rheumatology, 61(5), 1911-1918. https://dx.doi.org/10.1093/rheumatology/keab694 1462-0324 https://hdl.handle.net/10356/162794 10.1093/rheumatology/keab694 34554232 2-s2.0-85129998023 5 61 1911 1918 en Rheumatology © The Author(s) 2021. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved.
institution Nanyang Technological University
building NTU Library
continent Asia
country Singapore
Singapore
content_provider NTU Library
collection DR-NTU
language English
topic Science::Medicine
Systemic Lupus Erythematosus
Telemedicine
spellingShingle Science::Medicine
Systemic Lupus Erythematosus
Telemedicine
Au Eong, Jonathan T. W.
Lateef, Aisha
Liang, Shen
Lim, Sandy H. H.
Tay, Sen Hee
Mak, Anselm
Cho, Jiacai
Impact of teleconsultation on subsequent disease activity and flares in patients with systemic lupus erythematosus
description Objectives: Despite the widespread adoption of teleconsultations amid the COVID-19 pandemic, their safety in SLE patients has not been evaluated. Here, we examined subsequent disease activity and flares among SLE patients who received teleconsultation vs in-person consultation. To discern differences in physicians' prescription behaviour during both forms of consultations, we compared corticosteroid dose adjustments. Methods: We studied adult SLE patients who were seen between 1 February 2020 and 1 February 2021. At each patient-visit, rheumatologists utilized phone/video teleconsultation or physical consultation at their discretion. Disease activity was assessed with SLE Disease Activity Index 2000 (SLEDAI-2K) and flares were defined by the SELENA-SLEDAI Flare Index (SFI). We derived a propensity score for patients who were chosen for physical consultation. Multivariable generalized estimation equations were used to analyse SLEDAI-2k and flare at the next visit, adjusted for the propensity score. Results: A total of 435 visits were recorded, of which 343 (78.9%) were physical visits and 92 (21.1%) were teleconsultations. The modality of consultation did not predict flare [OR for physical consultation (95% CI) 0.42 (0.04, 5.04), P =0.49] or SLEDAI-2k at the next visit [estimate of coefficient for physical consultation (95% CI) -0.19 (-0.80, 0.43), P =0.55]. Adjustments of prednisolone dosages were comparable between the two forms of visits [OR for physical consultation (95% CI) 1.34 (0.77, 2.34), P =0.30]. Conclusion: SLE disease activity and flares at the subsequent visit were similar between teleconsultations and physical consultations. Medication prescription behaviour, determined using adjustment in corticosteroid dosages, was not different between the two forms of visits.
author2 Lee Kong Chian School of Medicine (LKCMedicine)
author_facet Lee Kong Chian School of Medicine (LKCMedicine)
Au Eong, Jonathan T. W.
Lateef, Aisha
Liang, Shen
Lim, Sandy H. H.
Tay, Sen Hee
Mak, Anselm
Cho, Jiacai
format Article
author Au Eong, Jonathan T. W.
Lateef, Aisha
Liang, Shen
Lim, Sandy H. H.
Tay, Sen Hee
Mak, Anselm
Cho, Jiacai
author_sort Au Eong, Jonathan T. W.
title Impact of teleconsultation on subsequent disease activity and flares in patients with systemic lupus erythematosus
title_short Impact of teleconsultation on subsequent disease activity and flares in patients with systemic lupus erythematosus
title_full Impact of teleconsultation on subsequent disease activity and flares in patients with systemic lupus erythematosus
title_fullStr Impact of teleconsultation on subsequent disease activity and flares in patients with systemic lupus erythematosus
title_full_unstemmed Impact of teleconsultation on subsequent disease activity and flares in patients with systemic lupus erythematosus
title_sort impact of teleconsultation on subsequent disease activity and flares in patients with systemic lupus erythematosus
publishDate 2022
url https://hdl.handle.net/10356/162794
_version_ 1749179256411258880