Will 'the feeling of abandonment' remain? Persisting impacts of the Covid-19 pandemic on rheumatology patients and clinicians

• Published in: Rheumatology (Oxford, England) England), 2022-08, Vol.61 (9), p.3723-3736
• Main Authors: Sloan, Melanie, Harwood, Rupert, Gordon, Caroline, Bosley, Michael, Lever, Elliott, Modi, Rakesh, Blane, Moira, Brimicombe, James, Barrere, Colette, Holloway, Lynn, Sutton, Stephen, D'Cruz, David
• Format: Article
• Language: English
• Subjects: Clinical Science
• ISSN: 1462-0324; 1462-0332
• DOI: 10.1093/rheumatology/keab937

To better understand rheumatology patient and clinician pandemic-related experiences, medical relationships and behaviours in order to help identify the persisting impacts of the Covid-19 pandemic, and inform efforts to ameliorate the negative impacts and build-upon the positive ones. Rheumatology patients and clinicians completed surveys (Patients N = 1,543, Clinicians N = 111) and interviews (Patients N = 41, Clinicians N = 32) between April 2021 and August 2021. A cohort (N = 139) of systemic autoimmune rheumatic disease patients was also followed-up from March 2020 to April 2021. Analyses used sequential mixed methods. Pre-specified outcome measures included the Warwick-Edinburgh Mental wellbeing score (WEMWBS), satisfaction with care, and healthcare-behaviours. We identified multiple ongoing pandemic-induced/increased barriers to receiving care. The percentage of patients agreeing they were medically supported reduced from 74.4% pre-pandemic to 39.7% during-pandemic. Ratings for medical support, medical-security and trust were significantly (p< 0.001) positively correlated with patient WEMWBS and healthcare-behaviours, and decreased during the pandemic. Healthcare-seeking was reduced, potentially long-term, including from patients feeling 'abandoned' by clinicians, and a 'burden' from Government messaging to protect the NHS. Blame and distrust were frequent, particularly between primary and secondary care, and towards the UK Government, whom