Management of Rheumatic Diseases During the COVID‐19 pandemic: A National Veterans Affairs Survey of Rheumatologists

Singh, Jasvinder A.; Richards, John S; Chang, Elizabeth; Joseph, Amy; Ng, Bernard

OBJECTIVE: To assess the experience, views and opinions of rheumatology providers at Veterans Affairs (VA) facilities about rheumatic disease healthcare issues during the COVID‐19 pandemic. METHODS: We performed an anonymized cross‐sectional survey, conducted from April 16 to May 18, 2020, of VA rheumatology providers. We assessed provider perspective on COVID‐19 issues and resilience. RESULTS: Of the 153 eligible VA rheumatologists, 103 (67%) completed the survey. A significant proportion of providers reported ≥50% increase related to COVID‐19 in visits by: (1) telephone, 53%; (2) video‐based VA video connect (VVC), 44%; and (3) clinical video telehealth (CVT) with a facilitator, 29%. A majority of the responders were somewhat or very comfortable with technology for providing healthcare to established patients during COVID‐19 pandemic using: (1) telephone, 87%; (2) VA video connect (VVC), 64%; and (3) in‐person visits, 54%. A smaller proportion were comfortable with technology providing healthcare to new patients. At least 65% of rheumatologists considered telephone visits appropriate for established patients with gout, osteoporosis, polymyalgia rheumatica, stable rheumatoid arthritis, stable spondyloarthritis, or osteoarthritis; 32% reported a rheumatology medication shortage. Adjusted for age, sex and ethnicity, high provider resilience was associated with significantly higher odds ratio (OR) of comfort with technology for telephone (OR, 3.1 (95% CI, 1.1‐9.7)) and VVC visits for new patients (OR, 4.7 (95% CI, 1.4‐15.7)). CONCLUSIONS: A better understanding of COVID‐19 rheumatic disease healthcare issues using a health‐system approach can better inform providers, improve provider satisfaction and have positive effects on the care of Veterans with rheumatic disease.