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dc.contributor.authorSloan, Melanie
dc.contributor.authorHarwood, Rupert
dc.contributor.authorGordon, Caroline
dc.contributor.authorBosley, Michael
dc.contributor.authorLever, Elliott
dc.contributor.authorModi, Rakesh Narendra
dc.contributor.authorBlane, Moira
dc.contributor.authorBrimicombe, James
dc.contributor.authorBarrere, Colette
dc.contributor.authorHolloway, Lynn
dc.contributor.authorSutton, Stephen
dc.contributor.authorD'Cruz, David
dc.date.accessioned2022-03-04T00:30:31Z
dc.date.available2022-03-04T00:30:31Z
dc.date.issued2022-01-06
dc.identifier.issn1462-0324
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/334655
dc.description.abstractOBJECTIVE: 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. METHODS: 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. RESULTS: 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 <10% of clinicians felt had supported clinicians during the pandemic. Clinicians' efforts were reported to be impeded by inefficient administration systems, and chronic understaffing, suggestive of the pandemic having exposed and exacerbated existing healthcare-system weaknesses. CONCLUSION: Without concerted action-such as rebuilding trust, improved administrative systems, and more support for clinicians-barriers to care and negative impacts of the pandemic on trust, medical relationships, medical-security and patient help-seeking may persist longer-term. TRIAL REGISTRATION: This study is part of a pre-registered longitudinal multi-stage trial, the LISTEN study (ISRCTN-14966097), with later Covid-related additions registered in March 2021, including a pre-registered statistical analysis plan.
dc.format.mediumPrint-Electronic
dc.publisherOxford University Press (OUP)
dc.rightsAttribution-NonCommercial 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0/
dc.subjectCovid-19 pandemic
dc.subjectHealthcare-systems
dc.subjectNHS
dc.subjectRheumatology
dc.subjectchronic diseases
dc.subjecthealthcare behaviours
dc.subjectmedical security
dc.subjectmental health
dc.subjectpatient-clinician interactions
dc.subjecttelemedicine
dc.subjecttrust
dc.titleWill 'the feeling of abandonment' remain? Persisting impacts of the Covid-19 pandemic on rheumatology patients and clinicians.
dc.typeArticle
dc.publisher.departmentDepartment of Public Health And Primary Care, The Primary Care Unit
dc.date.updated2022-03-03T09:30:36Z
prism.publicationDate2022
prism.publicationNameRheumatology (Oxford)
prism.startingPagekeab937
dc.identifier.doi10.17863/CAM.82073
dcterms.dateAccepted2021-12-15
rioxxterms.versionofrecord10.1093/rheumatology/keab937
rioxxterms.versionVoR
dc.contributor.orcidModi, Rakesh Narendra [0000-0001-9651-6690]
dc.contributor.orcidBrimicombe, James [0000-0002-3443-3256]
dc.contributor.orcidSutton, Stephen [0000-0003-1610-0404]
dc.identifier.eissn1462-0332
rioxxterms.typeJournal Article/Review
cam.issuedOnline2022-01-06
cam.depositDate2022-03-03
pubs.licence-identifierapollo-deposit-licence-2-1
pubs.licence-display-nameApollo Repository Deposit Licence Agreement


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Attribution-NonCommercial 4.0 International
Except where otherwise noted, this item's licence is described as Attribution-NonCommercial 4.0 International