Telerheumatology: A Systematic Review

Abstract

Objective The aim of this systematic review was to identify and summarize the published literature on the use of telemedicine for the diagnosis and management of inflammatory and/or autoimmune rheumatic disease. Methods We performed a registered systematic search (CRD42015025382) for studies using the MEDLINE (1946-August 2015), Embase (1974-August 2015), Web of Science (1900-August 2015), and Scopus (1946-August 2015) databases. We included studies which demonstrated the use of telemedicine for diagnosis and/or management of inflammatory/autoimmune rheumatic disease. Following data extraction, we performed a descriptive analysis. Results Our literature search identified 1,468 potentially eligible studies. Of these, 20 reports were ultimately included in this review. Studies varied significantly in publication type, quality of evidence, and the reporting of methods. Most demonstrated a high risk of bias. Rheumatoid arthritis was the most commonly studied rheumatic disease (42% of patients). Studies demonstrated conflicting results regarding the effectiveness of telemedicine (18 found it effective, one found it effective but possibly harmful, and one found it ineffective). A limited number of studies included some component of a cost analysis (n=6, 16% of patients); all of these found telemedicine to be cost-effective. Conclusion Studies identified by this systematic review generally found telemedicine to be effective for the diagnosis and management of autoimmune/inflammatory rheumatic disease; however, there is limited evidence to support this conclusion. Further studies are needed to determine the best uses of telemedicine for the diagnosis and management of these conditions.

Tele‐Health Followup Strategy for Tight Control of Disease Activity in Rheumatoid Arthritis: Results of a Randomized Controlled Trial

“…In a randomized controlled study from 1989, Weinberger et al found tele‐consultations to improve physical health in patients with osteoarthritis . However, no studies have yet investigated the effect of monitoring disease activity through a tele‐health followup strategy in patients with RA , and most of the evidence on the efficacy of tele‐health interventions in chronic diseases is derived from studies within heart disease, obstructive lung disease, asthma, diabetes mellitus, and hypertension . This indicates, however, that tele‐health interventions seem to be both effective and time saving, as well as associated with a high degree of patient satisfaction .…”

Treat‐to‐target in rheumatoid arthritis: Evaluating the patient perspective using the Patient Opinion Real‐Time Anonymous Liaison system: The RA T2T PORTAL study

“…Patients may also need to consider the feasibility of attending frequent outpatient appointments, particularly as patients often have to travel significant distances to clinics in NZ as in Canada. Patient‐completed remote monitoring tools and tele‐rheumatology may be required to aid in the frequent review of patients in order to individualize their care within an RA T2T protocol …”

Rheumatology workforce issues in South Asia: Challenges and solutions

“…33 A systematic review on tele-rheumatology published in 2017 concluded that it is very good for the follow-up of patients diagnosed with RA. 38 Comparison of teleconferencing with a remote center with in-person consultation led to similar control of disease activity. However, it was felt that patient preference should be taken into account when offering these services as there was a significant dropout in both arms.…”

“…A systematic review on tele‐rheumatology published in 2017 concluded that it is very good for the follow‐up of patients diagnosed with RA . Comparison of teleconferencing with a remote center with in‐person consultation led to similar control of disease activity.…”