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Open Access 01-12-2023 | Care | Research

Learning from the COVID-19 pandemic: health care disturbances and telemedicine as an alternative rheumatology practice in Indonesia

Authors: Faisal Parlindungan, Sumariyono Sumariyono, Rudy Hidayat, Suryo Anggoro Kusumo Wibowo, Anna Ariane, Johanda Damanik, Abirianty Priandani Araminta, Khadijah Cahya Yunita

Published in: BMC Health Services Research | Issue 1/2023

Abstract

Background

Coronavirus disease 2019 (COVID-19) affects health care services. Our aim was to assess health care disruptions, treatment interruptions, and telemedicine reception regarding autoimmune rheumatic diseases (ARDs) in Indonesia.

Method

A cross-sectional population online-based questionnaire was conducted in Indonesia from September to December 2021.

Results

A total of 311 ARD patients were included, of whom 81 (26.0%) underwent consultations via telemedicine during the COVID-19 pandemic. The respondents showed increased concern about their susceptibility to COVID-19 (score of 3.9/5). Approximately 81 (26.0%) avoided hospital visits, and 76 (24.4%) stopped taking the medication without medical advice. Respondents’ concerns correlated with their social distancing behaviors (p value 0.000, r 0.458). Respondent concerns, behaviors, and blocked access to the hospital during the pandemic were associated with avoiding hospital visits (p value 0.014; 0.001; 0.045; 0.008). Sex was associated with stopping medication (p value 0.005). In multivariate analysis, blocked access and sex remained significant. Approximately 81 (26%) respondents who used telemedicine services during the COVID-19 pandemic as an alternative medical consultation method showed high satisfaction (3.8/5).

Conclusion

Health care disruptions and treatment interruptions were affected by patients’ internal and external factors during the COVID-19 pandemic. Telemedicine may be the best option to address barriers to health care access in Indonesia’s rheumatology practice during and after the pandemic situation.

Available only for authorised users

Li J, Liu HH, Yin XD, Li CC, Wang J. COVID-19 illness and autoimmune diseases: recent insights. Inflamm Res. 2021;70(4):1. https://doi.org/10.1007/S00011-021-01446-1.CrossRef

Ministry of Home Affair. Java And Bali. Published online August. 2021;2:1–23. Instruction Of The Minister Of Internal Affairs Number 27 Of 2021: Implementation Of Limitations For Community Activities Level 4, Level 3, And Level 2 Corona Virus Disease 2019.

Ministry of Home Affair. Instruction Of The Minister Of Affairs Number 28 Of 2021. Sumatera, Kalimantan, Sulawesi, Nusa Tenggara, Maluku And Papua. Published online August. 2021;2:1–11. Implementation Of Restrictions For Community Activities Level 4 Corona Virus Disease 2019.

Caso F, Costa L, Ruscitti P, et al. Could Sars-coronavirus-2 trigger autoimmune and/or autoinflammatory mechanisms in genetically predisposed subjects? Autoimmun Rev. 2020;19(5):102524. https://doi.org/10.1016/J.AUTREV.2020.102524.CrossRefPubMedPubMedCentral

D’Silva KM, Jorge A, Cohen A, et al. COVID-19 outcomes in patients with systemic autoimmune rheumatic Diseases compared to the General Population: a US Multicenter, comparative cohort study. Arthritis Rheumatol. 2021;73(6):914–20. https://doi.org/10.1002/ART.41619.CrossRefPubMedPubMedCentral

George MD, Baker JF, Banerjee S, et al. Social Distancing, Health Care Disruptions, Telemedicine Use, and treatment interruption during the COVID-19 pandemic in patients with or without Autoimmune Rheumatic Disease. ACR Open Rheumatol. 2021;3(6):381–9. https://doi.org/10.1002/ACR2.11239.CrossRefPubMedPubMedCentral

López-Medina C, Ladehesa-Pineda L, Gómez-García I, et al. Treatment adherence during the COVID-19 pandemic and the impact of confinement on disease activity and emotional status: a survey in 644 rheumatic patients. Jt bone spine. 2021;88(2):105085. https://doi.org/10.1016/J.JBSPIN.2020.105085.CrossRef

Pope JE. What does the COVID-19 Pandemic Mean for Rheumatology Patients? Curr Treatm Opt Rheumatol. 2020;6(2):71–4. https://doi.org/10.1007/S40674-020-00145-Y.CrossRefPubMedPubMedCentral

Bergman M, Saffore CD, Kim KJ, et al. Healthcare Resource Use in patients with Immune-Mediated conditions treated with targeted Immunomodulators during COVID-19 pandemic: a retrospective claims analysis. Adv Ther. 2021;38(10):5302–16. https://doi.org/10.1007/S12325-021-01906-4.CrossRefPubMedPubMedCentral

10.

Hasanah A, Hardiawan D, Marrosa J, Ramadhan A, Dariatno Sihaloho E, Yudistira AM. Behavioral Changes in Accessing Outpatient Care During the Covid-19 Pandemic.Jurnal Ekonomi Kesehatan Indonesia. 2021;6(1).

11.

Nugraha B, Wahyuni LK, Laswati H, Kusumastuti P, Tulaar AB, Gutenbrunner C. COVID-19 pandemic in Indonesia: Situation and challenges of rehabilitation medicine in Indonesia. Acta Med Indones. 2020;52(3):299.PubMed

12.

World Health Organization. Pulse Survey on Continuity of Essential Health Care Services during the COVID-19 Pandemic: Interim Report 27 August 2020.; 2021.

13.

World Health Organization. Second Round of the National Pulse Survey on Continuity of Essential Health Services during the COVID-19 Pandemic: January-March 2021.; 2021.

14.

Ahmed S, Grainger R, Santosa A, et al. APLAR recommendations on the practice of telemedicine in rheumatology. Int J Rheum Dis. 2022;25(3):247–58. https://doi.org/10.1111/1756-185X.14286.CrossRefPubMed

15.

Ministry of Health. Regulation Of The Minister Of Health Of The Republic Of Indonesia Number 20 Year. Published online August. 2019;7:1–16. 2019 Concerning Implementation Of Telemedicine Services Between Health Service Facilities.

16.

Indonesian Medical Council. Indonesian Medical Council regulation number 74 of 2020 concerning Clinical Authority and Medical Practice through Telemedicine during the Corona Virus Disease 2019 (COVID-19) pandemic in Indonesia. Published online April. 2020;30:1–9.

17.

Gkrouzman E, Wu DD, Jethwa H, Abraham S. Telemedicine in Rheumatology at the Advent of the COVID-19 pandemic. HSS J. 2020;16(Suppl 1):108. https://doi.org/10.1007/S11420-020-09810-3.CrossRefPubMedPubMedCentral

18.

Rezaian MM, Brent LH, Roshani S, et al. Rheumatology Care using Telemedicine. Telemed J E Health. 2020;26(3):335–40. https://doi.org/10.1089/TMJ.2018.0256.CrossRefPubMed

19.

Hollander JE, Carr BG. Virtually Perfect? Telemedicine for Covid-19. NEJM. 2020;382(18):1679–81. https://doi.org/10.1056/NEJMp2003539. CrossRefPubMed

20.

So H, Szeto CC, Tam LS. Patient acceptance of using telemedicine for follow-up of lupus nephritis in the COVID-19 outbreak. Ann Rheum Dis. 2021;80(6):e97–7. https://doi.org/10.1136/ANNRHEUMDIS-2020-218220.CrossRefPubMed

21.

Tornero-Molina J, Sánchez-Alonso F, Fernández-Prada M, Bris-Ochaita ML, Sifuentes-Giraldo A, Vidal-Fuentes J. Tele-Rheumatology during the COVID-19 pandemic. Reumatol Clin. 2020;18:157–63. https://doi.org/10.1016/J.REUMA.2020.10.004.CrossRefPubMedPubMedCentral

22.

Widayanti AW, Green JA, Heydon S, Norris P. Health-Seeking behavior of people in Indonesia: a narrative review. J Epidemiol Glob Health. 2020;10(1):6. https://doi.org/10.2991/JEGH.K.200102.001.CrossRefPubMedPubMedCentral

23.

Tam LS, Tanaka Y, Handa R, et al. Updated APLAR consensus statements on care for patients with rheumatic diseases during the COVID-19 pandemic. Int J Rheum Dis. 2021;24(6):733–45. https://doi.org/10.1111/1756-185X.14124.CrossRefPubMedPubMedCentral

24.

Mikuls TR, Johnson SR, Fraenkel L, et al. American College of Rheumatology Guidance for the management of Rheumatic Disease in Adult Patients during the COVID-19 pandemic: Version 3. Arthritis Rheumatol. 2021;73(2):e1–e12. https://doi.org/10.1002/art.41596.CrossRefPubMed

25.

Mikuls TR, Johnson SR, Fraenkel L, et al. American College of Rheumatology Guidance for the management of Rheumatic Disease in Adult Patients during the COVID-19 pandemic: Version 1. Arthritis rheumatol. 2020;72(8):1241–51. https://doi.org/10.1002/ART.41301.CrossRefPubMed

26.

Fragoulis GE, Evangelatos G, Arida A, et al. Treatment adherence of patients with systemic rheumatic diseases in COVID-19 pandemic. Ann Rheum Dis. 2021;80(4):e60–0. https://doi.org/10.1136/ANNRHEUMDIS-2020-217935.CrossRefPubMed

27.

Michaud K, Wipfler K, Shaw Y, et al. Experiences of patients with rheumatic Diseases in the United States during Early days of the COVID-19 pandemic. ACR Open Rheumatol. 2020;2(6):335–43. https://doi.org/10.1002/ACR2.11148.CrossRefPubMedPubMedCentral

28.

Pineda-Sic RA, Galarza-Delgado DA, Serna-Peña G, et al. Treatment adherence behaviours in rheumatic diseases during COVID-19 pandemic: a latin american experience. Ann Rheum Dis. 2021;80(6):e85–5. https://doi.org/10.1136/ANNRHEUMDIS-2020-218198.CrossRefPubMed

29.

Khabbazi A, Kavandi H, Paribanaem R, Khabbazi R, Malek Mahdavi A. Adherence to medication in patients with rheumatic diseases during COVID-19 pandemic. Ann Rheum Dis. 2020;0(0):1–2. https://doi.org/10.1136/ANNRHEUMDIS-2020-218756.CrossRef

30.

Midão L, Almada M, Carrilho J, Sampaio R, Costa E. Pharmacological adherence behavior changes during COVID-19 outbreak in a Portugal Patient Cohort. Int J Environ Res Public Health. 2022;19(3):1135. https://doi.org/10.3390/IJERPH19031135.CrossRefPubMedPubMedCentral

31.

Alfieri A, Yogianti F. Impact of pandemic COVID-19 on dermatology and venereology outpatient clinic in a tertiary referral hospital in Yogyakarta, Indonesia. Dermatol Rep. 2021;13(3). https://doi.org/10.4081/DR.2021.9381.

32.

Prabowo NA, Apriningsih H, Dirgahayu P et al. The Decrease in Hospital Visits at Universitas Sebelas Maret Hospital Due to the Level of Stress and Fear of COVID 19. ICoSIHSN 2020. 2021;33. doi:https://doi.org/10.2991/AHSR.K.210115.021

33.

Lukito AAC, Widyaningrum K. Why do inpatient visits decrease during the Covid-19 pandemic? A Case Study in Hospital, Malang Regency. Jurnal Kedokteran Brawijaya. Published online July. 2022;11. https://doi.org/10.21776/UB.JKB.2021.031.02.3S.

34.

Setyono H, Alifianto U, Wijanarko F, et al. The impact of the pandemic on neurosurgical services: a study from a coronavirus disease 2019 referral hospital in Surakarta. Surg Neurol Int. 2021;12(128). https://doi.org/10.25259/SNI_150_2021.

35.

Oluyede L, Cochran AL, Wolfe M, Prunkl L, McDonald N. Addressing transportation barriers to health care during the COVID-19 pandemic: perspectives of care coordinators. Transp Res Part A Policy Pract. 2022;159:157. https://doi.org/10.1016/J.TRA.2022.03.010.CrossRefPubMedPubMedCentral

36.

Jones MT, Arif R, Rai A. Patient experiences with Telemedicine in a National Health Service Rheumatology Outpatient Department during Coronavirus Disease-19. J Patient Exp. 2021;8:1–7. https://doi.org/10.1177/23743735211034973.CrossRef

37.

Mortezavi M, Lokineni S, Garg M, Chen YL, Ramsey A. Rheumatology patient satisfaction with Telemedicine during the COVID-19 pandemic in the United States. J Patient Exp. 2021;8:1–6. https://doi.org/10.1177/23743735211008825.CrossRef

38.

Cliffe S, Stevenson K. Patient experiences of virtual consultation during COVID 19: a musculoskeletal service evaluation. Musculoskelet Care. 2021;19(3):380–3. https://doi.org/10.1002/MSC.1534.CrossRef

39.

40.

Putri LP, Russell DJ, O’Sullivan BG, Meliala A, Kippen R. A critical review of definitions of rural areas in Indonesia and implications for health workforce policy and research. Health Res Policy Syst. 2022;20(1). https://doi.org/10.1186/S12961-022-00847-W.

41.

Putri LP, O’Sullivan BG, Russell DJ, Kippen R. Factors associated with increasing rural doctor supply in Asia-Pacific LMICs: a scoping review. Hum Resour Health. 2020;18(1). https://doi.org/10.1186/S12960-020-00533-4.

42.

Song Y, Bernard L, Jorgensen C, Dusfour G, Pers YM. The Challenges of Telemedicine in Rheumatology. Front Med (Lausanne). 2021;8:746219. https://doi.org/10.3389/FMED.2021.746219.CrossRefPubMed

Title: Learning from the COVID-19 pandemic: health care disturbances and telemedicine as an alternative rheumatology practice in Indonesia
Authors: Faisal Parlindungan
Sumariyono Sumariyono
Rudy Hidayat
Suryo Anggoro Kusumo Wibowo
Anna Ariane
Johanda Damanik
Abirianty Priandani Araminta
Khadijah Cahya Yunita
Publication date: 01-12-2023
Publisher: BioMed Central
Keywords: Care
COVID-19
Telemedicine
Published in: BMC Health Services Research / Issue 1/2023
Electronic ISSN: 1472-6963
DOI: https://doi.org/10.1186/s12913-023-09389-5

2024 ASCO Annual Meeting

Springer Medicine

Learning from the COVID-19 pandemic: health care disturbances and telemedicine as an alternative rheumatology practice in Indonesia

Abstract

Background

Method

Results

Conclusion

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Background

Method

Results

Conclusion

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