Predictive factors in RA patients to achieve remission through online surveys in the pandemic setting

By :
    Estefanía Fajardo
    Periodista científica de Global Rheumatology by PANLAR.

30 August, 2021
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This will be one of the oral papers presented at PANLAR 2021, which aims to analyze health care through virtuality in the context of the covid-19 pandemic.




EF: Hello everyone and welcome to a new Global Rheumatology video blog. We will start by doing a series of interviews of what will be the oral presentations at the PANLAR 2021 Congress. We're here with Dr. Wilson Bautista. Doctor, welcome.


WB: Estefania, good morning, a pleasure to greet you today as well as all the Global Rheumatology audience. 


EF: Doctor, tell us, what is this presentation that you will give at PANLAR 2021 going to be about?


WB: Well, first of all we want to thank the PANLAR Scientific Committee for the acceptance of this research work that we elaborated in the Rheumatology service together with all the colleagues of the research group during the pandemic scenario. It is a very interesting study where we evaluated the predictive factors in patients with rheumatoid arthritis to achieve remission of disease activity using the assessment of online questionnaires, through a platform, in these patients considering the situation we had to live during the coronavirus, where face-to-face consultations were canceled, and we had to make a remote or virtual evaluation of these patients that we should perform routinely in the follow-up of the disease.


EF: Doctor, how many patients were followed and for how long was this follow-up?


WB: We have been doing it since last year, we started more or less in April until the end of 2020, and we included more than 600 patients who answered the questionnaires. We sent them a response link through a platform called Recap and the patients who answered these three questionnaires were the input we used to carry out this research project.


We mainly use three questionnaires, the first is the Rapid 3 which allows us to evaluate disease activity in patients with rheumatoid arthritis, we evaluate the HAQ HQ questionnaire which also allows us to evaluate the functional status of the patient, and, for the emotional component, we use the questionnaire which allows us to evaluate the presence or absence of emotional symptoms, especially anxiety or depression. 


EF: Bearing in mind that we were in a pandemic and that the issue of mental health was important in that emotional issue, what were the main findings or responses that you also considered?

WB: Yes, Estefanía, and they were, let's say, very interesting results that we had hypothesized would come out with the results of this research work and that we were finally able to prove.


We observed a high frequency of emotional symptoms in these patients measured by the questionnaire, where we found very high scores in these patients and we clearly assumed that these results were given not only by the underlying disease, but also by the epidemiological context that we were experiencing last year, in 2020, so we could conclude that the burden of emotional impact on patients with rheumatoid arthritis was very significant and probably increased in the context of the pandemic and this was also associated as a predictive factor of disease activity. That is, those patients who were more emotionally disturbed by symptoms of anxiety or depression were those patients who were less able to control disease activity.


EF: The virtual theme has been a constant and we can see it even in the congresses. How was this process of changing from receiving patients and seeing them physically to this virtual theme? So much so that it generated this theme for you to present it.


WB: Yes, Estefania. Let's say that last year's biological situation made us modify everything we had been doing in the clinical scenario, in the follow-up and monitoring of these patients in a very abrupt way. We had to modify that way of evaluating patients and move from 100% face-to-face as we had been doing traditionally, to scenarios where virtuality has become more important, so from the point of view of the working group of us as rheumatologists it has been modified, even this year it still persists and, probably, we think that this will also persist, We think that this will also persist for many years in a hybrid form, both face-to-face and virtual, and this impact has not only been reflected in the area of care, but also from the perspective of patients if we take into account that many of them were not used to routinely using electronic devices or answering online surveys or questionnaires. 


For them it also meant an abrupt change to which they had to adapt and adopt within the process of the new normality, where the educational part was essential, and we as a group also made educational pills and sent information continuously to support the patients in this somewhat abrupt transition that this situation left us with.


EF: Doctor, what is next? Are you going to continue with this study, considering that we are now continuing with the issue of covid, with vaccination and, precisely, with post-covid, or what is going to continue?


WB: It is a very interesting road ahead, Estefania. And, in that scenario, we also have several lines of research in order to generate data that will allow us to evaluate, the implementation of this virtual strategy, the first one was to increase the sample size by including more patients who respond to these surveys virtually and, therefore, to make a much more robust analysis from a statistical point of view with a more representative sample size.


The second step that we also want to do is to make a comparison between two groups, one group of the patients assessed virtually, as is the objective of this work, and the second to compare it with the patients assessed in person. We want to make a comparison between these two scenarios, virtual and face-to-face, and observe or study whether there are any differences in relation to achieving the therapeutic goals in these patients and, above all, evaluate what we can improve in the virtual scenario in order to get a little closer to the face-to-face scenario. 


And the third line is also to optimize more questionnaires or to make a validation in Spanish of other questionnaires that are also used to follow up these patients with rheumatoid arthritis, looking for much shorter forms or shorter questionnaires that take less time for patients, since it is different to answer a questionnaire and in front of the doctor and another very different to answer it already, for example from a tablet or a cell phone, especially if the number of questions is very long and time-consuming.


EF: Finally, an invitation to all those who are watching this interview to join the PANLAR 2021 sessions.


WB: Of course, Estefania, an invitation to all this virtual audience and to the readers of Global Rheumatology to participate in a very active way in all the academic sessions of this PANLAR 2021 congress, which will have a very interesting content with a high scientific level, and also to invite you to participate in the presentation of both oral and written, of course, will offer us very important and applicable information in the clinical practice for all the members of the community.


EF: Thank you very much for this participation in Global Rheumatology. 


WB: To you, Estefania. Thank you very much and, again, a very special greeting to the entire Global team.



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