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Waiting lists for symptomatic joint arthritis are not benign: prioritizing patients for surgery in the setting of COVID-19.

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Title: Waiting lists for symptomatic joint arthritis are not benign: prioritizing patients for surgery in the setting of COVID-19.
Authors: Morris, JA
Super, J
Huntley, D
Ashdown, T
Harland, W
Anakwe, R
Item Type: Journal Article
Abstract: Aim: Restarting elective services presents a challenge to restore and improve many of the planned patient care pathways which have been suspended during the response to the COVID-19 pandemic. A significant backlog of planned elective work has built up representing a considerable volume of patient need. We aimed to investigate the health status, quality of life, and the impact of delay for patients whose referrals and treatment for symptomatic joint arthritis had been delayed as a result of the response to COVID-19. Methods: We interviewed 111 patients referred to our elective outpatient service and whose first appointments had been cancelled as a result of the response to the COVID-19 pandemic. Results: Patients reported significant impacts on their health status and quality of life. Overall, 79 (71.2%) patients reported a further deterioration in their condition while waiting, with seven (6.3%) evaluating their health status as 'worse than death'. Conclusions: Waiting lists are clearly not benign and how to prioritize patients, their level of need, and access to assessment and treatment must be more sophisticated than simply relying on the length of time a patient has been waiting. This paper supports the contention that patients awaiting elective joint arthroplasty report significant impacts on their quality of life and health status. This should be given appropriate weight when patients are prioritized for surgery as part of the recovery of services following the COVID-19 pandemic. Elective surgery should not be seen as optional surgery-patients do not see it in this way.
Issue Date: Aug-2020
Date of Acceptance: 1-Aug-2020
URI: http://hdl.handle.net/10044/1/86425
DOI: 10.1302/2633-1462.18.BJO-2020-0112.R1
ISSN: 2049-4394
Publisher: British Editorial Society of Bone and Joint Surgery
Start Page: 508
End Page: 511
Journal / Book Title: Bone and Joint Journal
Volume: 1
Issue: 8
Copyright Statement: © 2020 Author(s) et al. This is an open- access article distributed under the terms of the Creative Commons Attributions licence (CC- BY- NC- ND), which permits unrestricted use, distribution, and reproduction in any medium, but not for commercial gain, pro-vided the original author and source are credited.
Keywords: COVID-19
arthritis
health status
joint arthroplasty
waiting list
COVID-19
arthritis
health status
joint arthroplasty
waiting list
Publication Status: Published
Conference Place: England
Online Publication Date: 2020-08-26
Appears in Collections:Department of Surgery and Cancer
Imperial College London COVID-19



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