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Outpatient hospital attendances in people with rheumatoid arthritis during the COVID-19 pandemic and beyond: a cohort study in three nations of the UK

Ruth E Costello Orcid Logo, Michael Parker, Jonathan Kennedy, Sinead Brophy Orcid Logo, Amir Mehrkar, Sebastian Bacon, Ben Goldacre Orcid Logo, Brian MacKenna, Dave Evans, Laurie A Tomlinson Orcid Logo, Rosemary J Hollick Orcid Logo, Jenny H Humphreys, (The OpenSAFELY Collective, The RHEUMAPS Study Investigators and the LH&W NCS (or CONVALESCENCE) Collaborative), Alex J Walker, Brian MacKenna, Peter Inglesby, Ben Goldacre, Helen J Curtis, Caroline E Morton, Jessica Morley, Amir Mehrkar, Sebastian C J Bacon, George Hickman, Richard Croker, David Evans, Tom Ward, Nicholas J DeVito, Louis Fisher, Amelia C A Green, Jon Massey, Rebecca M Smith, William J Hulme, Simon Davy, Colm D Andrews, Lisa E M Hopcroft, Henry Drysdale, Iain Dillingham, Robin Y Park, Rose Higgins, Christine Cunningham, Milan Wiedemann, Linda Nab, Steven Maude, Orla Macdonald, Ben F C Butler-Cole, Thomas O'Dwyer, Catherine L Stables, Christopher Wood, Andrew D Brown, Victoria Speed, Lucy Bridges, Andrea L Schaffer, Caroline E Walters, Christopher T Rentsch, Krishnan Bhaskaran, Anna Schultze, Elizabeth J Williamson, Helen I McDonald, Laurie A Tomlinson, Rohini Mathur, Rosalind M Eggo, Kevin Wing, Angel Y S Wong, John Tazare, Richard Grieve, Daniel J Grint, Sinead Langan, Kathryn E Mansfield, Ian J Douglas, Stephen J W Evans, Liam Smeeth, Jemma L Walker, Viyaasan Mahalingasivam, Harriet Forbes, Thomas E Cowling, Emily L Herrett, Ruth E Costello, Bang Zheng, Edward P K Parker, Christopher Bates, Jonathan Cockburn, John Parry, Frank Hester, Sam Harper, Shaun O'Hanlon, Alex Eavis, Richard Jarvis, Dima Avramov, Paul Griffiths, Aaron Fowles, Nasreen Parkes, Brian Nicholson, Rafael Perera, David Harrison, Kamlesh Khunti, Jonathan A C Sterne, Jennifer Quint, Nishi Chaturvedi, Chloe Park, Alisia Carnemolla, Dylan Williams, Anika Knueppel, Andy Boyd, Emma L Turner, Katharine M Evans, Richard Thomas, Samantha Berman, Stela McLachlan, Matthew Crane, Rebecca Whitehorn, Jacqui Oakley, Diane Foster, Hannah Woodward, Kirsteen C Campbell, Nicholas Timpson, Alex Kwong, Ana Goncalves Soares, Gareth Griffith, Renin Toms, Louise Jones, Herbert Annie, Ruth Mitchell, Tom Palmer, Jonathan Sterne, Venexia Walker, Lizzie Huntley, Laura Fox, Rachel Denholm, Rochelle Knight, Kate Northstone, Arun Kanagaratnam, Elsie Horne, Harriet Forbes, Teri North, Kurt Taylor, Marwa A L Arab, Scott Walker, Jose I C Coronado, Arun S Karthikeyan, George Ploubidis, Bettina Moltrecht, Charlotte Booth, Sam Parsons, Bozena Wielgoszewska, Charis Bridger-Staatz, Claire Steves, Ellen Thompson, Paz Garcia, Nathan Cheetham, Ruth Bowyer, Maxim Freydin, Amy Roberts, Ben Goldacre, Alex Walker, Jess Morley, William Hulme, Linda Nab, Louis Fisher, Brian MacKenna, Colm Andrews, Helen Curtis, Lisa Hopcroft, Amelia Green, Praveetha Patalay, Jane Maddock, Kishan Patel, Jean Stafford, Wels Jacques, Kate Tilling, John Macleod, Eoin McElroy, Anoop Shah, Richard Silverwood, Spiros Denaxas, Robin Flaig, Daniel McCartney, Archie Campbell, Laurie Tomlinson, John Tazare, Bang Zheng, Liam Smeeth, Emily Herrett, Thomas Cowling, Kate Mansfield, Ruth E Costello, Kevin Wang, Kathryn Mansfield, Viyaasan Mahalingasivam, Ian Douglas, Sinead Langan, Sinead Brophy, Michael Parker, Jonathan Kennedy, Rosie McEachan, John Wright, Kathryn Willan, Ellena Badrick, Gillian Santorelli, Tiffany Yang, Bo Hou, Andrew Steptoe, Di Gessa Giorgio, Jingmin Zhu, Paola Zaninotto, Angela Wood, Genevieve Cezard, Samantha Ip, Tom Bolton, Alexia Sampri, Elena Rafeti, Fatima Almaghrabi, Aziz Sheikh, Syed A Shah, Vittal Katikireddi, Richard Shaw, Olivia Hamilton, Michael Green, Theocharis Kromydas, Daniel Kopasker, Felix Greaves, Robert Willans, Fiona Glen, Steve Sharp, Alun Hughes, Andrew Wong, Lee Hamill Howes, Alicja Rapala, Lidia Nigrelli, Fintan McArdle, Chelsea Beckford, Betty Raman, Richard Dobson, Amos Folarin, Callum Stewart, Yatharth Ranjan, Jd Carpentieri, Laura Sheard, Chao Fang, Sarah Baz, Andy Gibson, John Kellas, Stefan Neubauer, Stefan Piechnik, Elena Lukaschuk, Laura C Saunders, James M Wild, Stephen Smith, Peter Jezzard, Elizabeth Tunnicliffe, Zeena-Britt Sanders, Lucy Finnigan, Vanessa Ferreira, Mark Green, Rebecca Rhead, Milla Kibble, Yinghui Wei, Agnieszka Lemanska, Francisco Perez-Reche, Dominik Piehlmaier, Lucy Teece, Edward Parker, Rosemary J Hollick, Corri Black, Sinead Brophy, Ernest Choy, Gary Macfarlane, Louise Bennett, Lorna Philip, Michelle Stevenson, Denise McFarlane, Laura Moir, Ian Allotay, Philip Bell, Amanda Cheesley, Charlotte Marlow, Farzana Kausir, Emily Lam, Inga Wood, Michael Parker, Jonathan Kennedy

Rheumatology, Volume: 65, Issue: 1, Start page: keaf559

Swansea University Authors: Sinead Brophy Orcid Logo, Michael Parker, Jonathan Kennedy

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DOI (Published version): 10.1093/rheumatology/keaf559

Abstract

Objectives: We aimed to estimate how rheumatology outpatient hospital attendances have changed since the COVID-19 pandemic and determine demographic characteristics associated with observed changes. Methods: Using three primary and secondary care electronic health record datasets in England (with th...

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Published in: Rheumatology
ISSN: 1462-0324 1462-0332
Published: Oxford University Press (OUP) 2026
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa70816
first_indexed 2025-11-03T10:51:37Z
last_indexed 2026-02-20T04:21:28Z
id cronfa70816
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fullrecord <?xml version="1.0"?><rfc1807><datestamp>2026-02-18T15:02:56.1003144</datestamp><bib-version>v2</bib-version><id>70816</id><entry>2025-11-03</entry><title>Outpatient hospital attendances in people with rheumatoid arthritis during the COVID-19 pandemic and beyond: a cohort study in three nations of the UK</title><swanseaauthors><author><sid>84f5661b35a729f55047f9e793d8798b</sid><ORCID>0000-0001-7417-2858</ORCID><firstname>Sinead</firstname><surname>Brophy</surname><name>Sinead Brophy</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>a4dfe07a6b18fdf6d537962b8f24fbdf</sid><firstname>Michael</firstname><surname>Parker</surname><name>Michael Parker</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>08163d1f58d7fefcb1c695bcc2e0ef68</sid><ORCID/><firstname>Jonathan</firstname><surname>Kennedy</surname><name>Jonathan Kennedy</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2025-11-03</date><deptcode>MEDS</deptcode><abstract>Objectives: We aimed to estimate how rheumatology outpatient hospital attendances have changed since the COVID-19 pandemic and determine demographic characteristics associated with observed changes. Methods: Using three primary and secondary care electronic health record datasets in England (with the approval of NHS England), Scotland, and Wales, we identified people with a diagnosis of rheumatoid arthritis (RA) before 01/04/2019. We determined the proportion of people with rheumatology hospital outpatient appointments each month (April 2019-December 2022 (Wales and Scotland), November 2023 (England)) and quantified changes using interrupted time-series analysis. We used logistic regression to determine characteristics associated with having fewer appointments compared with 2019. Results: We identified 145 065, 3,813 and 13 637 people coded with RA in England, Scotland, and Wales, respectively. At the start of the COVID-19 pandemic the number of rheumatology outpatient appointments dropped sharply across all nations. In England and Scotland, the percentage of monthly appointments has continued to decline. In Wales, while there was a gradual recovery, rheumatology services have not returned to pre-pandemic levels. In contrast, the number of appointments for other specialties has recovered in all nations. People with no rheumatology outpatient appointments were more often aged over 80, male, and living in rural areas. Ethnic minorities, those living in more deprived, and urban areas had fewer appointments after the start of the pandemic compared with 2019. Conclusion: For the first time, we compared healthcare use across three UK nations and found rheumatology outpatient appointments had not recovered to pre-COVID-19 pandemic levels, particularly in Scotland and England.</abstract><type>Journal Article</type><journal>Rheumatology</journal><volume>65</volume><journalNumber>1</journalNumber><paginationStart>keaf559</paginationStart><paginationEnd/><publisher>Oxford University Press (OUP)</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>1462-0324</issnPrint><issnElectronic>1462-0332</issnElectronic><keywords>Rheumatoid Arthritis, delivery of health care, inequalities, observational studies, organisation of health care</keywords><publishedDay>8</publishedDay><publishedMonth>1</publishedMonth><publishedYear>2026</publishedYear><publishedDate>2026-01-08</publishedDate><doi>10.1093/rheumatology/keaf559</doi><url/><notes/><college>COLLEGE NANME</college><department>Medical School</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>MEDS</DepartmentCode><institution>Swansea University</institution><apcterm>Another institution paid the OA fee</apcterm><funders>In England, the OpenSAFELY platform is principally funded by grants from: &#x2022; NHS England [2023-2025]; &#x2022; The Wellcome Trust (222097/Z/20/Z) [2020-2024]; &#x2022; MRC (MR/V015737/1) [2020-2021]. Additional contributions to OpenSAFELY have been funded by grants from: &#x2022; MRC via the National Core Study programme, Longitudinal Health and Wellbeing strand (MC_PC_20030, MC_PC_20059) [2020-2022] and the Data and Connectivity strand (MC_PC_20058) [2021-2022]; &#x2022; NIHR and MRC via the CONVALESCENCE programme (COV-LT-0009, MC_PC_20051) [2021-2024]; &#x2022; NHS England via the Primary Care Medicines Analytics Unit [2021-2024]. Funding for the RHEUMAPS study and creation and analysis of the Scotland and Wales datasets used in this study was provided by the Nuffield Foundation Oliver Bird Fund (grant number OBF/44000).</funders><projectreference/><lastEdited>2026-02-18T15:02:56.1003144</lastEdited><Created>2025-11-03T10:42:18.0022193</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Health Data Science</level></path><authors><author><firstname>Ruth E</firstname><surname>Costello</surname><orcid>0000-0003-2709-6666</orcid><order>1</order></author><author><firstname>Michael</firstname><surname>Parker</surname><order>2</order></author><author><firstname>Jonathan</firstname><surname>Kennedy</surname><order>3</order></author><author><firstname>Sinead</firstname><surname>Brophy</surname><orcid>0000-0001-7417-2858</orcid><order>4</order></author><author><firstname>Amir</firstname><surname>Mehrkar</surname><order>5</order></author><author><firstname>Sebastian</firstname><surname>Bacon</surname><order>6</order></author><author><firstname>Ben</firstname><surname>Goldacre</surname><orcid>0000-0002-5127-4728</orcid><order>7</order></author><author><firstname>Brian</firstname><surname>MacKenna</surname><order>8</order></author><author><firstname>Dave</firstname><surname>Evans</surname><order>9</order></author><author><firstname>Laurie A</firstname><surname>Tomlinson</surname><orcid>0000-0001-8848-9493</orcid><order>10</order></author><author><firstname>Rosemary J</firstname><surname>Hollick</surname><orcid>0000-0001-6558-7189</orcid><order>11</order></author><author><firstname>Jenny H</firstname><surname>Humphreys</surname><order>12</order></author><author><firstname>(The OpenSAFELY Collective, The RHEUMAPS Study Investigators and the LH&amp;W NCS (or CONVALESCENCE)</firstname><surname>Collaborative)</surname><order>13</order></author><author><firstname>Alex J</firstname><surname>Walker</surname><order>14</order></author><author><firstname>Brian</firstname><surname>MacKenna</surname><order>15</order></author><author><firstname>Peter</firstname><surname>Inglesby</surname><order>16</order></author><author><firstname>Ben</firstname><surname>Goldacre</surname><order>17</order></author><author><firstname>Helen J</firstname><surname>Curtis</surname><order>18</order></author><author><firstname>Caroline E</firstname><surname>Morton</surname><order>19</order></author><author><firstname>Jessica</firstname><surname>Morley</surname><order>20</order></author><author><firstname>Amir</firstname><surname>Mehrkar</surname><order>21</order></author><author><firstname>Sebastian C J</firstname><surname>Bacon</surname><order>22</order></author><author><firstname>George</firstname><surname>Hickman</surname><order>23</order></author><author><firstname>Richard</firstname><surname>Croker</surname><order>24</order></author><author><firstname>David</firstname><surname>Evans</surname><order>25</order></author><author><firstname>Tom</firstname><surname>Ward</surname><order>26</order></author><author><firstname>Nicholas J</firstname><surname>DeVito</surname><order>27</order></author><author><firstname>Louis</firstname><surname>Fisher</surname><order>28</order></author><author><firstname>Amelia C A</firstname><surname>Green</surname><order>29</order></author><author><firstname>Jon</firstname><surname>Massey</surname><order>30</order></author><author><firstname>Rebecca M</firstname><surname>Smith</surname><order>31</order></author><author><firstname>William J</firstname><surname>Hulme</surname><order>32</order></author><author><firstname>Simon</firstname><surname>Davy</surname><order>33</order></author><author><firstname>Colm D</firstname><surname>Andrews</surname><order>34</order></author><author><firstname>Lisa E M</firstname><surname>Hopcroft</surname><order>35</order></author><author><firstname>Henry</firstname><surname>Drysdale</surname><order>36</order></author><author><firstname>Iain</firstname><surname>Dillingham</surname><order>37</order></author><author><firstname>Robin 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spelling 2026-02-18T15:02:56.1003144 v2 70816 2025-11-03 Outpatient hospital attendances in people with rheumatoid arthritis during the COVID-19 pandemic and beyond: a cohort study in three nations of the UK 84f5661b35a729f55047f9e793d8798b 0000-0001-7417-2858 Sinead Brophy Sinead Brophy true false a4dfe07a6b18fdf6d537962b8f24fbdf Michael Parker Michael Parker true false 08163d1f58d7fefcb1c695bcc2e0ef68 Jonathan Kennedy Jonathan Kennedy true false 2025-11-03 MEDS Objectives: We aimed to estimate how rheumatology outpatient hospital attendances have changed since the COVID-19 pandemic and determine demographic characteristics associated with observed changes. Methods: Using three primary and secondary care electronic health record datasets in England (with the approval of NHS England), Scotland, and Wales, we identified people with a diagnosis of rheumatoid arthritis (RA) before 01/04/2019. We determined the proportion of people with rheumatology hospital outpatient appointments each month (April 2019-December 2022 (Wales and Scotland), November 2023 (England)) and quantified changes using interrupted time-series analysis. We used logistic regression to determine characteristics associated with having fewer appointments compared with 2019. Results: We identified 145 065, 3,813 and 13 637 people coded with RA in England, Scotland, and Wales, respectively. At the start of the COVID-19 pandemic the number of rheumatology outpatient appointments dropped sharply across all nations. In England and Scotland, the percentage of monthly appointments has continued to decline. In Wales, while there was a gradual recovery, rheumatology services have not returned to pre-pandemic levels. In contrast, the number of appointments for other specialties has recovered in all nations. People with no rheumatology outpatient appointments were more often aged over 80, male, and living in rural areas. Ethnic minorities, those living in more deprived, and urban areas had fewer appointments after the start of the pandemic compared with 2019. Conclusion: For the first time, we compared healthcare use across three UK nations and found rheumatology outpatient appointments had not recovered to pre-COVID-19 pandemic levels, particularly in Scotland and England. Journal Article Rheumatology 65 1 keaf559 Oxford University Press (OUP) 1462-0324 1462-0332 Rheumatoid Arthritis, delivery of health care, inequalities, observational studies, organisation of health care 8 1 2026 2026-01-08 10.1093/rheumatology/keaf559 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University Another institution paid the OA fee In England, the OpenSAFELY platform is principally funded by grants from: • NHS England [2023-2025]; • The Wellcome Trust (222097/Z/20/Z) [2020-2024]; • MRC (MR/V015737/1) [2020-2021]. Additional contributions to OpenSAFELY have been funded by grants from: • MRC via the National Core Study programme, Longitudinal Health and Wellbeing strand (MC_PC_20030, MC_PC_20059) [2020-2022] and the Data and Connectivity strand (MC_PC_20058) [2021-2022]; • NIHR and MRC via the CONVALESCENCE programme (COV-LT-0009, MC_PC_20051) [2021-2024]; • NHS England via the Primary Care Medicines Analytics Unit [2021-2024]. Funding for the RHEUMAPS study and creation and analysis of the Scotland and Wales datasets used in this study was provided by the Nuffield Foundation Oliver Bird Fund (grant number OBF/44000). 2026-02-18T15:02:56.1003144 2025-11-03T10:42:18.0022193 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Ruth E Costello 0000-0003-2709-6666 1 Michael Parker 2 Jonathan Kennedy 3 Sinead Brophy 0000-0001-7417-2858 4 Amir Mehrkar 5 Sebastian Bacon 6 Ben Goldacre 0000-0002-5127-4728 7 Brian MacKenna 8 Dave Evans 9 Laurie A Tomlinson 0000-0001-8848-9493 10 Rosemary J Hollick 0000-0001-6558-7189 11 Jenny H Humphreys 12 (The OpenSAFELY Collective, The RHEUMAPS Study Investigators and the LH&W NCS (or CONVALESCENCE) Collaborative) 13 Alex J Walker 14 Brian MacKenna 15 Peter Inglesby 16 Ben Goldacre 17 Helen J Curtis 18 Caroline E Morton 19 Jessica Morley 20 Amir Mehrkar 21 Sebastian C J Bacon 22 George Hickman 23 Richard Croker 24 David Evans 25 Tom Ward 26 Nicholas J DeVito 27 Louis Fisher 28 Amelia C A Green 29 Jon Massey 30 Rebecca M Smith 31 William J Hulme 32 Simon Davy 33 Colm D Andrews 34 Lisa E M Hopcroft 35 Henry Drysdale 36 Iain Dillingham 37 Robin Y Park 38 Rose Higgins 39 Christine Cunningham 40 Milan Wiedemann 41 Linda Nab 42 Steven Maude 43 Orla Macdonald 44 Ben F C Butler-Cole 45 Thomas O'Dwyer 46 Catherine L Stables 47 Christopher Wood 48 Andrew D Brown 49 Victoria Speed 50 Lucy Bridges 51 Andrea L Schaffer 52 Caroline E Walters 53 Christopher T Rentsch 54 Krishnan Bhaskaran 55 Anna Schultze 56 Elizabeth J Williamson 57 Helen I McDonald 58 Laurie A Tomlinson 59 Rohini Mathur 60 Rosalind M Eggo 61 Kevin Wing 62 Angel Y S Wong 63 John Tazare 64 Richard Grieve 65 Daniel J Grint 66 Sinead Langan 67 Kathryn E Mansfield 68 Ian J Douglas 69 Stephen J W Evans 70 Liam Smeeth 71 Jemma L Walker 72 Viyaasan Mahalingasivam 73 Harriet Forbes 74 Thomas E Cowling 75 Emily L Herrett 76 Ruth E Costello 77 Bang Zheng 78 Edward P K Parker 79 Christopher Bates 80 Jonathan Cockburn 81 John Parry 82 Frank Hester 83 Sam Harper 84 Shaun O'Hanlon 85 Alex Eavis 86 Richard Jarvis 87 Dima Avramov 88 Paul Griffiths 89 Aaron Fowles 90 Nasreen Parkes 91 Brian Nicholson 92 Rafael Perera 93 David Harrison 94 Kamlesh Khunti 95 Jonathan A C Sterne 96 Jennifer Quint 97 Nishi Chaturvedi 98 Chloe Park 99 Alisia Carnemolla 100 Dylan Williams 101 Anika Knueppel 102 Andy Boyd 103 Emma L Turner 104 Katharine M Evans 105 Richard Thomas 106 Samantha Berman 107 Stela McLachlan 108 Matthew Crane 109 Rebecca Whitehorn 110 Jacqui Oakley 111 Diane Foster 112 Hannah Woodward 113 Kirsteen C Campbell 114 Nicholas Timpson 115 Alex Kwong 116 Ana Goncalves Soares 117 Gareth Griffith 118 Renin Toms 119 Louise Jones 120 Herbert Annie 121 Ruth Mitchell 122 Tom Palmer 123 Jonathan Sterne 124 Venexia Walker 125 Lizzie Huntley 126 Laura Fox 127 Rachel Denholm 128 Rochelle Knight 129 Kate Northstone 130 Arun Kanagaratnam 131 Elsie Horne 132 Harriet Forbes 133 Teri North 134 Kurt Taylor 135 Marwa A L Arab 136 Scott Walker 137 Jose I C Coronado 138 Arun S Karthikeyan 139 George Ploubidis 140 Bettina Moltrecht 141 Charlotte Booth 142 Sam Parsons 143 Bozena Wielgoszewska 144 Charis Bridger-Staatz 145 Claire Steves 146 Ellen Thompson 147 Paz Garcia 148 Nathan Cheetham 149 Ruth Bowyer 150 Maxim Freydin 151 Amy Roberts 152 Ben Goldacre 153 Alex Walker 154 Jess Morley 155 William Hulme 156 Linda Nab 157 Louis Fisher 158 Brian MacKenna 159 Colm Andrews 160 Helen Curtis 161 Lisa Hopcroft 162 Amelia Green 163 Praveetha Patalay 164 Jane Maddock 165 Kishan Patel 166 Jean Stafford 167 Wels Jacques 168 Kate Tilling 169 John Macleod 170 Eoin McElroy 171 Anoop Shah 172 Richard Silverwood 173 Spiros Denaxas 174 Robin Flaig 175 Daniel McCartney 176 Archie Campbell 177 Laurie Tomlinson 178 John Tazare 179 Bang Zheng 180 Liam Smeeth 181 Emily Herrett 182 Thomas Cowling 183 Kate Mansfield 184 Ruth E Costello 185 Kevin Wang 186 Kathryn Mansfield 187 Viyaasan Mahalingasivam 188 Ian Douglas 189 Sinead Langan 190 Sinead Brophy 191 Michael Parker 192 Jonathan Kennedy 193 Rosie McEachan 194 John Wright 195 Kathryn Willan 196 Ellena Badrick 197 Gillian Santorelli 198 Tiffany Yang 199 Bo Hou 200 Andrew Steptoe 201 Di Gessa Giorgio 202 Jingmin Zhu 203 Paola Zaninotto 204 Angela Wood 205 Genevieve Cezard 206 Samantha Ip 207 Tom Bolton 208 Alexia Sampri 209 Elena Rafeti 210 Fatima Almaghrabi 211 Aziz Sheikh 212 Syed A Shah 213 Vittal Katikireddi 214 Richard Shaw 215 Olivia Hamilton 216 Michael Green 217 Theocharis Kromydas 218 Daniel Kopasker 219 Felix Greaves 220 Robert Willans 221 Fiona Glen 222 Steve Sharp 223 Alun Hughes 224 Andrew Wong 225 Lee Hamill Howes 226 Alicja Rapala 227 Lidia Nigrelli 228 Fintan McArdle 229 Chelsea Beckford 230 Betty Raman 231 Richard Dobson 232 Amos Folarin 233 Callum Stewart 234 Yatharth Ranjan 235 Jd Carpentieri 236 Laura Sheard 237 Chao Fang 238 Sarah Baz 239 Andy Gibson 240 John Kellas 241 Stefan Neubauer 242 Stefan Piechnik 243 Elena Lukaschuk 244 Laura C Saunders 245 James M Wild 246 Stephen Smith 247 Peter Jezzard 248 Elizabeth Tunnicliffe 249 Zeena-Britt Sanders 250 Lucy Finnigan 251 Vanessa Ferreira 252 Mark Green 253 Rebecca Rhead 254 Milla Kibble 255 Yinghui Wei 256 Agnieszka Lemanska 257 Francisco Perez-Reche 258 Dominik Piehlmaier 259 Lucy Teece 260 Edward Parker 261 Rosemary J Hollick 262 Corri Black 263 Sinead Brophy 264 Ernest Choy 265 Gary Macfarlane 266 Louise Bennett 267 Lorna Philip 268 Michelle Stevenson 269 Denise McFarlane 270 Laura Moir 271 Ian Allotay 272 Philip Bell 273 Amanda Cheesley 274 Charlotte Marlow 275 Farzana Kausir 276 Emily Lam 277 Inga Wood 278 Michael Parker 279 Jonathan Kennedy 280 70816__36268__07f76a6a68764d228e35d7587a5c45ab.pdf 70816.VoR.pdf 2026-02-18T15:00:26.8890039 Output 1230520 application/pdf Version of Record true ©The Author(s) 2025. This is an Open Access article distributed under the terms of the Creative Commons Attribution License. true Eng https://creativecommons.org/licenses/by/4.0/)
title Outpatient hospital attendances in people with rheumatoid arthritis during the COVID-19 pandemic and beyond: a cohort study in three nations of the UK
spellingShingle Outpatient hospital attendances in people with rheumatoid arthritis during the COVID-19 pandemic and beyond: a cohort study in three nations of the UK
Sinead Brophy
Michael Parker
Jonathan Kennedy
title_short Outpatient hospital attendances in people with rheumatoid arthritis during the COVID-19 pandemic and beyond: a cohort study in three nations of the UK
title_full Outpatient hospital attendances in people with rheumatoid arthritis during the COVID-19 pandemic and beyond: a cohort study in three nations of the UK
title_fullStr Outpatient hospital attendances in people with rheumatoid arthritis during the COVID-19 pandemic and beyond: a cohort study in three nations of the UK
title_full_unstemmed Outpatient hospital attendances in people with rheumatoid arthritis during the COVID-19 pandemic and beyond: a cohort study in three nations of the UK
title_sort Outpatient hospital attendances in people with rheumatoid arthritis during the COVID-19 pandemic and beyond: a cohort study in three nations of the UK
author_id_str_mv 84f5661b35a729f55047f9e793d8798b
a4dfe07a6b18fdf6d537962b8f24fbdf
08163d1f58d7fefcb1c695bcc2e0ef68
author_id_fullname_str_mv 84f5661b35a729f55047f9e793d8798b_***_Sinead Brophy
a4dfe07a6b18fdf6d537962b8f24fbdf_***_Michael Parker
08163d1f58d7fefcb1c695bcc2e0ef68_***_Jonathan Kennedy
author Sinead Brophy
Michael Parker
Jonathan Kennedy
author2 Ruth E Costello
Michael Parker
Jonathan Kennedy
Sinead Brophy
Amir Mehrkar
Sebastian Bacon
Ben Goldacre
Brian MacKenna
Dave Evans
Laurie A Tomlinson
Rosemary J Hollick
Jenny H Humphreys
(The OpenSAFELY Collective, The RHEUMAPS Study Investigators and the LH&W NCS (or CONVALESCENCE) Collaborative)
Alex J Walker
Brian MacKenna
Peter Inglesby
Ben Goldacre
Helen J Curtis
Caroline E Morton
Jessica Morley
Amir Mehrkar
Sebastian C J Bacon
George Hickman
Richard Croker
David Evans
Tom Ward
Nicholas J DeVito
Louis Fisher
Amelia C A Green
Jon Massey
Rebecca M Smith
William J Hulme
Simon Davy
Colm D Andrews
Lisa E M Hopcroft
Henry Drysdale
Iain Dillingham
Robin Y Park
Rose Higgins
Christine Cunningham
Milan Wiedemann
Linda Nab
Steven Maude
Orla Macdonald
Ben F C Butler-Cole
Thomas O'Dwyer
Catherine L Stables
Christopher Wood
Andrew D Brown
Victoria Speed
Lucy Bridges
Andrea L Schaffer
Caroline E Walters
Christopher T Rentsch
Krishnan Bhaskaran
Anna Schultze
Elizabeth J Williamson
Helen I McDonald
Laurie A Tomlinson
Rohini Mathur
Rosalind M Eggo
Kevin Wing
Angel Y S Wong
John Tazare
Richard Grieve
Daniel J Grint
Sinead Langan
Kathryn E Mansfield
Ian J Douglas
Stephen J W Evans
Liam Smeeth
Jemma L Walker
Viyaasan Mahalingasivam
Harriet Forbes
Thomas E Cowling
Emily L Herrett
Ruth E Costello
Bang Zheng
Edward P K Parker
Christopher Bates
Jonathan Cockburn
John Parry
Frank Hester
Sam Harper
Shaun O'Hanlon
Alex Eavis
Richard Jarvis
Dima Avramov
Paul Griffiths
Aaron Fowles
Nasreen Parkes
Brian Nicholson
Rafael Perera
David Harrison
Kamlesh Khunti
Jonathan A C Sterne
Jennifer Quint
Nishi Chaturvedi
Chloe Park
Alisia Carnemolla
Dylan Williams
Anika Knueppel
Andy Boyd
Emma L Turner
Katharine M Evans
Richard Thomas
Samantha Berman
Stela McLachlan
Matthew Crane
Rebecca Whitehorn
Jacqui Oakley
Diane Foster
Hannah Woodward
Kirsteen C Campbell
Nicholas Timpson
Alex Kwong
Ana Goncalves Soares
Gareth Griffith
Renin Toms
Louise Jones
Herbert Annie
Ruth Mitchell
Tom Palmer
Jonathan Sterne
Venexia Walker
Lizzie Huntley
Laura Fox
Rachel Denholm
Rochelle Knight
Kate Northstone
Arun Kanagaratnam
Elsie Horne
Harriet Forbes
Teri North
Kurt Taylor
Marwa A L Arab
Scott Walker
Jose I C Coronado
Arun S Karthikeyan
George Ploubidis
Bettina Moltrecht
Charlotte Booth
Sam Parsons
Bozena Wielgoszewska
Charis Bridger-Staatz
Claire Steves
Ellen Thompson
Paz Garcia
Nathan Cheetham
Ruth Bowyer
Maxim Freydin
Amy Roberts
Ben Goldacre
Alex Walker
Jess Morley
William Hulme
Linda Nab
Louis Fisher
Brian MacKenna
Colm Andrews
Helen Curtis
Lisa Hopcroft
Amelia Green
Praveetha Patalay
Jane Maddock
Kishan Patel
Jean Stafford
Wels Jacques
Kate Tilling
John Macleod
Eoin McElroy
Anoop Shah
Richard Silverwood
Spiros Denaxas
Robin Flaig
Daniel McCartney
Archie Campbell
Laurie Tomlinson
John Tazare
Bang Zheng
Liam Smeeth
Emily Herrett
Thomas Cowling
Kate Mansfield
Ruth E Costello
Kevin Wang
Kathryn Mansfield
Viyaasan Mahalingasivam
Ian Douglas
Sinead Langan
Sinead Brophy
Michael Parker
Jonathan Kennedy
Rosie McEachan
John Wright
Kathryn Willan
Ellena Badrick
Gillian Santorelli
Tiffany Yang
Bo Hou
Andrew Steptoe
Di Gessa Giorgio
Jingmin Zhu
Paola Zaninotto
Angela Wood
Genevieve Cezard
Samantha Ip
Tom Bolton
Alexia Sampri
Elena Rafeti
Fatima Almaghrabi
Aziz Sheikh
Syed A Shah
Vittal Katikireddi
Richard Shaw
Olivia Hamilton
Michael Green
Theocharis Kromydas
Daniel Kopasker
Felix Greaves
Robert Willans
Fiona Glen
Steve Sharp
Alun Hughes
Andrew Wong
Lee Hamill Howes
Alicja Rapala
Lidia Nigrelli
Fintan McArdle
Chelsea Beckford
Betty Raman
Richard Dobson
Amos Folarin
Callum Stewart
Yatharth Ranjan
Jd Carpentieri
Laura Sheard
Chao Fang
Sarah Baz
Andy Gibson
John Kellas
Stefan Neubauer
Stefan Piechnik
Elena Lukaschuk
Laura C Saunders
James M Wild
Stephen Smith
Peter Jezzard
Elizabeth Tunnicliffe
Zeena-Britt Sanders
Lucy Finnigan
Vanessa Ferreira
Mark Green
Rebecca Rhead
Milla Kibble
Yinghui Wei
Agnieszka Lemanska
Francisco Perez-Reche
Dominik Piehlmaier
Lucy Teece
Edward Parker
Rosemary J Hollick
Corri Black
Sinead Brophy
Ernest Choy
Gary Macfarlane
Louise Bennett
Lorna Philip
Michelle Stevenson
Denise McFarlane
Laura Moir
Ian Allotay
Philip Bell
Amanda Cheesley
Charlotte Marlow
Farzana Kausir
Emily Lam
Inga Wood
Michael Parker
Jonathan Kennedy
format Journal article
container_title Rheumatology
container_volume 65
container_issue 1
container_start_page keaf559
publishDate 2026
institution Swansea University
issn 1462-0324
1462-0332
doi_str_mv 10.1093/rheumatology/keaf559
publisher Oxford University Press (OUP)
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Health Data Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Health Data Science
document_store_str 1
active_str 0
description Objectives: We aimed to estimate how rheumatology outpatient hospital attendances have changed since the COVID-19 pandemic and determine demographic characteristics associated with observed changes. Methods: Using three primary and secondary care electronic health record datasets in England (with the approval of NHS England), Scotland, and Wales, we identified people with a diagnosis of rheumatoid arthritis (RA) before 01/04/2019. We determined the proportion of people with rheumatology hospital outpatient appointments each month (April 2019-December 2022 (Wales and Scotland), November 2023 (England)) and quantified changes using interrupted time-series analysis. We used logistic regression to determine characteristics associated with having fewer appointments compared with 2019. Results: We identified 145 065, 3,813 and 13 637 people coded with RA in England, Scotland, and Wales, respectively. At the start of the COVID-19 pandemic the number of rheumatology outpatient appointments dropped sharply across all nations. In England and Scotland, the percentage of monthly appointments has continued to decline. In Wales, while there was a gradual recovery, rheumatology services have not returned to pre-pandemic levels. In contrast, the number of appointments for other specialties has recovered in all nations. People with no rheumatology outpatient appointments were more often aged over 80, male, and living in rural areas. Ethnic minorities, those living in more deprived, and urban areas had fewer appointments after the start of the pandemic compared with 2019. Conclusion: For the first time, we compared healthcare use across three UK nations and found rheumatology outpatient appointments had not recovered to pre-COVID-19 pandemic levels, particularly in Scotland and England.
published_date 2026-01-08T07:31:00Z
_version_ 1858534544184967168
score 11.098005

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