EXPERIENCE OF TELECONSULTING CARE FOR HEALTH CARE PROFESSIONALS AND PATIENTS WITH RHEUMATOID ARTHRITIS, IN THE HEALTH EMERGENCY DUE TO COVID-19

Objectives: Rheumatoid arthritis (RA) is a disease highly vulnerable to COVID-19, a factor that caused an impact on everyday practice and the implementation of tele care assistance. Our goal was to understand the experiences of RA patients and health care professionals (HCP) in the implementation of a non-face-to-face multidisciplinary consultation model in the health emergency caused by COVID-19. Methods: Qualitative descriptive exploratory study. Semi-structured interviews (telephone or video-based depending on the participant preferences) were carried out that analyzed the experiences of RA patients and HCP who cared for them in a specialized center in Bogota (Colombia). All interviews were audio-recorded, with prior informed consent of the participants, and were conducted by researchers trained in qualitative designs. Inclusion criteria: Adult RA patients evaluated in the tele consultation modality on at least two occasions, patients treated in the face-to-face consultation modality on at least two occasions and health professionals who have carried out at least 25 tele consultations, in the context of the health emergency due to COVID-19. It was analyzed following the Taylor-Bogdan proposal. Results: 36 interviews were conducted, 29 (80.5%) corresponded to RA patients (69% were attended by tele consultation and 31%, through face-toface consultation);and 7 (19.4%) corresponded to HCP. Characteristics of participants are shown in table 1 and 2. Four categories emerged configuring the experience of the subjects (patients and professionals) in a scenario of high vulnerability and uncertainty derived from the COVID-19 pandemic: Factors present in communication, information and communications technology (ICT) management, family support and interaction, and adherence to treatment. In patients, mental health, pain, functional dependence, and quality of life, were the most affected dimensions. Resilience mechanisms such as adaptation and self-care measures emerged to minimize risks from pandemic. Conclusion: Clinical and social conditioning factors were identified, which may determine the relevance of tele consultation. The implementation of tele consultation should be accompanied by the training of HCP, digital literacy and investment in technological infrastructure to overcome barrier access. It is important to promote assertive communication processes in the professional-patient relationship mediated by ICT.