Objectives Despite the widespread adoption of teleconsultations amid the COVID-19 pandemic, their safety in SLE patients has not been evaluated. Here, we examined subsequent disease activity and flares among SLE patients who received teleconsultation vs in-person consultation. To discern differences in physicians’ prescription behaviour during both forms of consultations, we compared corticosteroid dose adjustments. Methods We studied adult SLE patients who were seen between 1 February 2020 and 1 February 2021. At each patient-visit, rheumatologists utilized phone/video teleconsultation or physical consultation at their discretion. Disease activity was assessed with SLE Disease Activity Index 2000 (SLEDAI-2K) and flares were defined by the SELENA-SLEDAI Flare Index (SFI). We derived a propensity score for patients who were chosen for physical consultation. Multivariable generalized estimation equations were used to analyse SLEDAI-2k and flare at the next visit, adjusted for the propensity score. Results A total of 435 visits were recorded, of which 343 (78.9%) were physical visits and 92 (21.1%) were teleconsultations. The modality of consultation did not predict flare [OR for physical consultation (95% CI) 0.42 (0.04, 5.04), P =0.49] or SLEDAI-2k at the next visit [estimate of coefficient for physical consultation (95% CI) −0.19 (−0.80, 0.43), P =0.55]. Adjustments of prednisolone dosages were comparable between the two forms of visits [OR for physical consultation (95% CI) 1.34 (0.77, 2.34), P =0.30]. Conclusion SLE disease activity and flares at the subsequent visit were similar between teleconsultations and physical consultations. Medication prescription behaviour, determined using adjustment in corticosteroid dosages, was not different between the two forms of visits.

中文翻译：

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远程会诊对系统性红斑狼疮患者后续疾病活动和发作的影响

目标 尽管在 COVID-19 大流行期间广泛采用远程会诊，但尚未评估其在 SLE 患者中的安全性。在这里，我们检查了接受远程会诊与面对面会诊的 SLE 患者随后的疾病活动和发作。为了辨别两种咨询形式中医生处方行为的差异，我们比较了皮质类固醇剂量调整。方法 我们研究了在 2020 年 2 月 1 日至 2021 年 2 月 1 日期间就诊的成年 SLE 患者。在每次患者就诊时，风湿病学家自行决定使用电话/视频远程会诊或身体会诊。使用 SLE 疾病活动指数 2000 (SLEDAI-2K) 评估疾病活动，并通过 SELENA-SLEDAI 耀斑指数 (SFI) 定义耀斑。我们得出了选择进行身体咨询的患者的倾向评分。多变量广义估计方程用于分析 SLEDAI-2k 和下一次就诊时的耀斑，并根据倾向得分进行调整。结果共记录就诊435次，其中物理就诊343次（78.9%），远程会诊92次（21.1%）。咨询方式未预测下一次就诊时的耀斑 [OR 身体咨询 (95% CI) 0.42 (0.04, 5.04), P = 0.49] 或 SLEDAI-2k [身体咨询系数估计 (95% CI) - 0.19 (-0.80, 0.43), P = 0.55]。两种形式的就诊之间的泼尼松龙剂量调整具有可比性 [OR 物理咨询 (95% CI) 1.34 (0.77, 2.34)，P = 0.30]。结论 远程会诊和身体会诊之间的 SLE 疾病活动性和随后就诊时的发作相似。通过调整皮质类固醇剂量确定的药物处方行为在两种形式的就诊之间没有差异。