P068 Exploring the impact of COVID-19 on self-management and healthcare provision in people with Inflammatory Arthritis: A qualitative study
Authors: Caton Emma , Chaplin Hema , Carpenter Lewis , Sweeney Melissa , Tung Hsiu , Souza Savia de , Norton Sam 
Published: April 2021

Background/Aims 

Inflammatory arthritis (IA) patients have been identified as being at greater risk of severe illness from COVID-19. It is likely that lockdown restrictions enforced by the UK government in response to the COVID-19 pandemic, and subsequent changes made to healthcare provisions, could impact patients’ abilities to effectively manage their condition. The aim of this study was to qualitatively explore the impact of COVID-19 and lockdown on self-management behaviours and healthcare provision in people with IA.

Methods 

Semi-structured interviews were conducted with 21 patients with IA from across the UK (as part of a larger longitudinal survey study exploring the impact of COVID-19 on health-related quality of life for people with IA). Participants who gave consent for contact, following the completion of the baseline survey study, were approached to take part in the qualitative interviews. The interview schedule was developed with a Patient Research Partner and consisted of eight main questions to explore participants’ experiences of the COVID-19 pandemic, including the impact of COVID-19 on their self-management behaviours and access to healthcare services. The interviews were conducted via telephone and were recorded and transcribed before being analysed using inductive thematic analysis.

Results 

Participants were aged between 24-72 (mean age 50.0, SD 15.6) and were mostly female (71%) and White British (86%). Four main themes were identified: impact of COVID-19 on medication adherence, impact of COVID-19 on physical activity, impact of COVID-19 on diet, and impact of COVID-19 on healthcare access. Subthemes focused on positive and negative changes made to these areas, as well as behaviours which remained consistent. Some participants expressed that the lockdown period had enabled them to increase their physical activity, improve their diet and maintain their usual medication regimen, whilst others noted that lockdown had had a negative impact on their self-management behaviours. For example, some patients decided to discontinue their medication during the pandemic due to concerns that it would make them more susceptible to severe consequences from COVID-19. In relation to healthcare provision, the most commonly reported change was the introduction of telephone appointments to replace face-to-face consultations. Several patients found the telephone appointments ineffective, especially if their disease was relatively uncontrolled. Nevertheless, participants understood why a remote approach had been implemented during the pandemic.

Conclusion 

COVID-19 has had an impact on patients’ abilities to manage their IA. Healthcare professionals need to recognise the impact of COVID-19 on patient self-management and healthcare provision to ensure that adequate understanding and support is available to patients who may have inadequate disease control as a result.

Disclosure 

E. Caton: None. H. Chaplin: None. L. Carpenter: None. M. Sweeney: None. H. Tung: None. S. de Souza: None. S. Norton: None.