375. Trends in medication interruptions and anxiety during the COVID-19 pandemic among patients with vasculitis
Creators: name: Dharia1, Tiffany
Publisher: name: Zenodo
Year: 2022
Subjects: Vasculitis
ANCA
Abstracts
Giant Cell Arthritis
MPA
GPA
EGPA
Takayasu
IgA vasculitis

description: <strong>Background/Objectives:</strong> The COVID-19 pandemic has had substantial impact on the care of patients with vasculitis, resulting in frequent interruptions in medication use during the pandemic. This study used longitudinal data to examine changes in anxiety and interruptions in medication use in patients with vasculitis during the COVID-19 pandemic. <strong>Methods:</strong> The Vasculitis Patient Powered Research Network online patient registry and partnering organizations invited members to complete a baseline survey (week 0) and then every 2 weeks until week 8, monthly until week 28, with a final survey at week 52. We analyzed patients with vasculitis who completed baseline surveys between March 29 and June 30, 2020 and completed at least one follow-up survey, with follow-up captured through May 2021. Changes over time in the frequency of interruptions in medication use due to COVID-19 concerns (among patients receiving immunosuppressive therapies who did not report a respiratory illness or COVID-19 diagnosis) and changes in PROMIS Anxiety T scores (population mean 50 with standard deviation of 10) were assessed using generalized estimating equation (GEE) models to account for within-person correlations, with models assessing changes in anxiety adjusted for baseline anxiety. Associations between anxiety and interruptions in medication use were also assessed with GEE models, and differences in reasons for interruptions in medication use compared in 2020 and 2021. <strong>Results:</strong> A total of 535 patients completed a median of 5 surveys (interquartile range 3-7). The mean age was 57 years, 79% were female, and the most common diagnoses were granulomatosis with polyangiitis, relapsing polychonitis and eosinophilic granulomatosis with polyangiitis (Table 1). Anxiety declined substantially over the course of the study with average PROMIS-Anxiety T-scores changing from 56.8 to 51.7 from March 2020 to May 2021 (p &lt; 0.001 for trend). In contrast, interruptions in medication use were more frequent in 2021 versus 2020 (12.1% versus 8.0% [OR 1.59 (95% CI 1.12-2.25)]. However, there were fewer responses to the survey in 2021 vs 2020. Flares did not change significantly from April through December of 2020 (p = 0.14 for trend) but increased from December to May of 2021 (p &lt; 0.001 for trend). Greater anxiety was associated with more medication interruptions in 2020 but not in 2021 (p = 0.005 for interaction). Reasons for interruptions in medication use differed in 2020 and 2021 (Table 1); the most common reason patients noted for an interruption their medication in 2020 was a fear of getting sick (46.6%) in 2020, while the most common reason in 2021 was physician recommendation (58.3%). <strong>Conclusion:</strong> Patients with vasculitis had high levels of anxiety at the start of the pandemic, but anxiety decreased close to general population averages by May of 2021. Interruptions in medication use increased in 2021, but were more commonly recommended by physicians and may have been related to interruptions occurring around the time of vaccination. A substantial proportion of interruptions in medication use was not recommended by physicians, however, highlighting the importance of regular communication between the patients and the healthcare team during public health crises to ensure optimal use of mediations. <strong>Disclosures</strong>: Peter Merkel has received consulting fees from AbbVie, AstraZeneca, Biogen, Boeringher-Ingelheim, Bristol-Myers Squibb, Celgene, ChemoCentryx, CSL Behring, Forbius, Genentech/Roche, Genzyme/Sanofi, GlaxoSmithKline, InflaRx, Insmed, Jannsen, Kiniksa, Magenta, Pfizer, Sparrow, and Talaris and research support from AstraZeneca, Boeringher-Ingelheim, Bristol-Myers Squibb, Celgene, ChemoCentryx, Forbius, Genentech/Roche, Genzyme/Sanofi, GlaxoSmithKline, and InflaRx and royalties from UpToDate. David Curtis, Kelly Gavigan, W Benjamin Nowell, and Shilpa Venkatachalam are employees of the Global Healthy Living Foundation (GHLF). GHLF receives grants, sponsorships and contracts from pharmaceutical manufacturers and private foundations. A full list of GHLF funders is publicly available here: https://www.ghlf.org/our-partners/. Michael George has received consulting fees from Abbvie and research funding from GlaxoSmithKline. Preliminary data presented here: https://www.asn-online.org/education/kidneyweek/2021/program-abstract.aspx?controlId=3611478.