Evaluation of a Non-Face-to-Face Multidisciplinary Health Care Model in a Population with Rheumatoid Arthritis Vulnerable to COVID-19 in a Health Emergency Situation

Abstract

This study evaluated a non-face-to-face-multidisciplinary consultation model in a population with rheumatoid arthritis (RA) during the COVID-19 pandemic. This is an analytical observational study of a prospective cohort with simple random sampling. RA patients were followed for 12 weeks (Jul–Oct 2020). Two groups were included: patients in telemedicine care (TM), and patients in the usual face-to-face care (UC). Patients could voluntarily change the care model (transition model (TR)). Activity of disease, quality of life, disability, therapeutic adherence, and self-care ability were analyzed. Bivariate analysis was performed. A qualitative descriptive exploratory study was conducted. At the beginning, 218 adults were included: (109/TM-109/UC). The groups didn’t differ in general characteristics. At the end of the study, there were no differences in TM: (n = 71). A significant (p < 0.05) decrease in adherence, and increase in self-care ability were found in UC (n = 18) and TR (n = 129). Seven patients developed COVID-19. Four categories emerged from the experience of the subjects in the qualitative assessment (factors present in communication, information and communication technologies management, family support and interaction, and adherence to treatment). The telemedicine model keeps RA patients stable without major differences compared to the usual care or mixed model.

Home‐Based Telemedicine in Rheumatology—A Scoping Review

“…Mean satisfaction scores (0–10 visual analog scale) were somewhat lower for telehealth group participants compared with the F2F group (8.8 vs 9.8), which the authors attributed primarily to the problems with their telehealth software application 23 . The second study was a three‐month prospective study from Colombia that found comparable disease activity in participants with RA for telemedicine and F2F care using standardized measures such as the Patient Activity Scale, Visual Analogue Scale (VAS), Disease Activity Score with 28 joint counts, and the Health Assessment Questionnaire 24 . Two studies included patients with SLE.…”

“…23 The second study was a three‐month prospective study from Colombia that found comparable disease activity in participants with RA for telemedicine and F2F care using standardized measures such as the Patient Activity Scale, Visual Analogue Scale (VAS), Disease Activity Score with 28 joint counts, and the Health Assessment Questionnaire. 24 Two studies included patients with SLE. One RCT from Hong Kong included 141 patients with lupus nephritis and found similar disease activity between telehealth and F2F care at 1 year using indices such as the SLE Disease Activity Index (SLEDAI) and Quality of Life (QoL) measures, highlighting the potential of telemedicine to provide equivalent lupus nephritis control.…”

Global Perspective on the Impact of the COVID‐19 Pandemic on Rheumatology and Health Equity

“…The scarcity of video calls impacted the ability of providers to make an accurate diagnosis and treatment plan. Nevertheless, one study demonstrated that in some Latin American settings, telehealth was useful for monitoring patients with stable RA (67). These findings suggested a mixed model could be an option for certain patients, in particular those who live in rural areas.…”

Novel insights into the management of rheumatoid arthritis: one year in review 2022

“…No significant differences were reported in the proportions of patients in low disease activity or remission as measured by Routine Assessment of Patient Index Data 3 (RAPID3) between those who incorporated telemedicine follow-up (52%) and in-person only (odds ratio [OR] 0.41, 95%CI 0.17-1.04, p=0.06). During COVID-19 pandemic, in a Colombian centre, 218 RA patients were prospectively monitored by following three models based on telemedicine, face-to-face usual care, and a mixed care allowing transitions between the other models (47). No significant differences were observed in the groups regarding functional status (HAQ) and other PROs (patient activity score [PAS], patient general assessment [PGA]).…”