The Clinical Impact of Electronic <scp>Patient‐Reported</scp> Outcome Measures in the Remote Monitoring of Inflammatory Arthritis: A Systematic Review and Meta‐analysis

Arumalla, Nikita; Chan, Chun K. D.; Gibson, Mark; Man, Yik L.; Adas, Maryam A; Norton, Sam; Galloway, James; Garrood, Toby

doi:10.1002/art.42559

Cited by 14 publications

(4 citation statements)

References 48 publications

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“… 6 We excluded studies that looked at remote monitoring because this was not in the scope of our definition for home‐based telehealth and has been covered by others. 10 …”

Section: Methodsmentioning

confidence: 99%

Home‐Based Telemedicine in Rheumatology—A Scoping Review

Venuturupalli,

Peck,

Jinka

et al. 2024

ACR Open Rheumatology

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ObjectiveWe performed a scoping review of the relevant literature on home‐based telehealth in rheumatology to understand its appropriate application in rheumatology practice.MethodsWe searched the Cochrane Library, PubMed, Web of Science, and scientific meeting abstracts to identify articles that specifically addressed telehealth suitability, barriers to telehealth, patient‐reported outcomes (PROs) collected in telehealth settings, and telehealth satisfaction. From the initial search of 4,882 studies, 23 reports were included. In addition, 10 abstracts were also eligible for analysis, resulting in a total of 33 articles: 2 randomized clinical trials, 9 prospective cohort studies, and 22 retrospective studies.ResultsWe found that triage appointments or predictive models could be helpful in selecting patients for telehealth and that telehealth interventions were appropriate for follow‐up of patients with systemic lupus erythematosus and inflammatory arthritis, but that conducting new patient visits over telehealth was not ideal. Barriers to telehealth include patient factors (age, technology access) and need for physician/process factors (eg, physical examinations). PROs collected in regular practice can be incorporated into telehealth. Several small, single‐center studies suggest that telehealth does not lead to negative outcomes compared with in‐person visits, and overall, patients report high patient satisfaction with telehealth. In several scenarios, home‐based telehealth was equivalent to in‐person visits with regard to patient outcomes and satisfaction.ConclusionThe widespread potential of telehealth to manage and deliver care for people with rheumatic disease is significant. As such, further research in the form of randomized controlled trials can help contribute to growing evidence that shapes telehealth implementation for patients with rheumatic diseases.

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“… 6 We excluded studies that looked at remote monitoring because this was not in the scope of our definition for home‐based telehealth and has been covered by others. 10 …”

Section: Methodsmentioning

confidence: 99%

Home‐Based Telemedicine in Rheumatology—A Scoping Review

Venuturupalli,

Peck,

Jinka

et al. 2024

ACR Open Rheumatology

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“…Adherence is key, as Remote Therapeutic Monitoring is a more active form of tracking, requiring providers and their staff to promote its ongoing use while analyzing the incoming data and patients to commit to participation. Furthermore, Remote Therapeutic Monitoring is useful only inasmuch as it is able to inform future patient care or contribute to real-world data about a condition and its treatment 27 , 28 . A recently published systematic literature review of the clinical impact of electronic patient reported outcome monitoring summarized 8 studies (7 of them in rheumatoid arthritis) as a digital intervention and showed that monitoring had a small impact on improving disease activity (standardized mean difference −0.15, 95% CI −0.27, −0.03) and more substantial impact on decreasing health care utilization through more effective triage (standardized mean difference −0.3, 95% CI −2.14, 0.28).…”

Section: History and Backgroundmentioning

confidence: 99%

Remote Therapeutic Monitoring in Rheumatic and Musculoskeletal Diseases: Opportunities and Implementation

Nowell

Curtis

2023

MRAJ

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Therapeutic Monitoring (RTM) is a new program in the United States that began in 2022 allowing electronic patient-reported outcomes (ePRO) and other patient-generated data to be reviewed by clinical staff between visits so that patients can receive clinical attention as needed. Remote Therapeutic Monitoring simultaneously enhances the capacity to generate prospective longitudinal data that may be useful for secondary research purposes. As many governmental and private insurance programs in the United States now provide reimbursement for Remote Therapeutic Monitoring, increasing numbers of rheumatologists may be incentivized to provide this service for their patient populations. Launched in 2015, the ArthritisPower® Research Registry and associated mobile and desktop application, registered with the Food & Drug Administration (FDA) as a Class I medical device, enables patients to track their disease across dozens of domains and to securely participate in voluntary research studies. ArthritisPower, in partnership with Illumination Health, has developed infrastructure and a clinical workflow for Remote Therapeutic Monitoring that will help rheumatologists more closely track their patients’ disease activity and flares, identify primary non-adherence, record changes in key health domains (e.g. fatigue, pain, physical function, mental health) and meet the needs for other data elements important for clinical care identified by individual providers. Ultimately, the approach to use digital health tools between visits seeks to improve clinical outcomes for patients with rheumatic and musculoskeletal diseases. This editorial review discusses the evolution of remote monitoring in rheumatologic care, describes the opportunities for physician reimbursement as of 2023, and provides a suggested workflow in order to establish Remote Therapeutic Monitoring within rheumatology practices.

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“…Ample papers exist about the value of RPM. [2][3][4][5][6][7][8][9] In 2022 EULAR points-to-consider for remote care were published to foster adoption of RPM, providing guidelines on where to position RPM in our practices. 10 But for many rheumatologists, the unanswered question remains the 'how to?'…”

Section: Key Messagesmentioning

confidence: 99%

“…None of the 8 studies with a total of 4473 demonstrated worsening of disease activity and face to face (F2F) could be safely reduced. 2 Most studies included patients with RA and used the RAPID-3 as the main ePROM instrument. Seppen et al proved in a recent randomised controlled trial (RCT) that remote care based on weekly e-PROMs in patients with RA with stable low disease activity was non-inferior to usual care in terms of the ΔDAS28-ESR and led to a 38% reduction in rheumatologist consultations.…”

Section: Introductionmentioning

confidence: 99%

Recommendation to implementation of remote patient monitoring in rheumatology: lessons learned and barriers to take

Hamann,

Knitza,

Kuhn

et al. 2023

RMD Open

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Remote patient monitoring (RPM) leverages advanced technology to monitor and manage patients’ health remotely and continuously. In 2022 European Alliance of Associations for Rheumatology (EULAR) points-to-consider for remote care were published to foster adoption of RPM, providing guidelines on where to position RPM in our practices. Sample papers and studies describe the value of RPM. But for many rheumatologists, the unanswered question remains the ‘how to?’ implement RPM.Using the successful, though not frictionless example of the Southmead rheumatology department, we address three types of barriers for the implementation of RPM: service, clinician and patients, with subsequent learning points that could be helpful for new teams planning to implement RPM. These address, but are not limited to, data governance, selecting high quality cost-effective solutions and ensuring compliance with data protection regulations. In addition, we describe five lacunas that could further improve RPM when addressed: establishing quality standards, creating a comprehensive database of available RPM tools, integrating data with electronic patient records, addressing reimbursement uncertainties and improving digital literacy among patients and healthcare professionals.

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The Clinical Impact of Electronic Patient‐Reported Outcome Measures in the Remote Monitoring of Inflammatory Arthritis: A Systematic Review and Meta‐analysis

Cited by 14 publications

References 48 publications

Home‐Based Telemedicine in Rheumatology—A Scoping Review

Home‐Based Telemedicine in Rheumatology—A Scoping Review

Remote Therapeutic Monitoring in Rheumatic and Musculoskeletal Diseases: Opportunities and Implementation

Recommendation to implementation of remote patient monitoring in rheumatology: lessons learned and barriers to take

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