Regina Taylor-Gjevre1, Bindu Nair1, Brenna Bath2,3, Udoka Okpalauwaekwe1, Meenu Sharma1, Erika Penz4, Catherine Trask3, Samuel Alan Stewart5. 1. Division of Rheumatology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada. 2. School of Physical Therapy, University of Saskatchewan, Saskatoon, SK, Canada. 3. Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada. 4. Division of Respirology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada. 5. Medical Informatics, Department of Community Health & Epidemiology, Dalhousie University, Halifax, NS, Canada.
Abstract
OBJECTIVE: The aim of the present study was to evaluate whether rheumatoid arthritis (RA) patients followed longitudinally using video-conferencing and inter-professional care support have comparable disease control to those followed in traditional in-person rheumatology clinics. METHODS: This was a randomized controlled trial for 85 RA patients allocated to eithertraditional in-person rheumatology follow-up or video-conferenced follow-up with urban-based rheumatologists and rural in-person physical therapist examiners. Follow-up was every 3 months for 9 months. Outcome measures included disease activity metrics (disease activity in 28 joints with CRP measure score [DAS28-CRP], and RA disease activity index [RADAI]), modified health assessment questionnaire (mHAQ), quality of life (EuroQOL five dimensions questionnaire [EQ5D]) and patient satisfaction (nine-item visit-specific satisfaction questionnaire [VSQ9]). RESULTS: Of 85 participants, 54 were randomized to the video-conferencing team model and 31 to the traditional clinic (control group). Dropout rates were high, with only 31 (57%) from the video-conferencing and 23 (74%) from the control group completing the study. The mean age for study participants was 56 years; 20% were male. Mean RA disease duration was 13.9 years. There were no significant between-group differences in DAS28-CRP, RADAI, mHAQor EQ5D scores at baseline or over the study period. Satisfaction rates were high in both groups. CONCLUSIONS: We found no evidence of a difference in effectiveness between inter-professional video-conferencing and traditional rheumatology clinic for both the provision of effective follow-up care and patient satisfaction for established RA patients. High dropout rates reinforce the need for consultation with patients' needs and preferences in developing models of care. While use of video-conferencing/telehealth technologies may be a distinct advantage for some patients, there may be loss of travel-related auxiliary benefits for others.
RCT Entities:
OBJECTIVE: The aim of the present study was to evaluate whether rheumatoid arthritis (RA) patients followed longitudinally using video-conferencing and inter-professional care support have comparable disease control to those followed in traditional in-person rheumatology clinics. METHODS: This was a randomized controlled trial for 85 RApatients allocated to either traditional in-person rheumatology follow-up or video-conferenced follow-up with urban-based rheumatologists and rural in-person physical therapist examiners. Follow-up was every 3 months for 9 months. Outcome measures included disease activity metrics (disease activity in 28 joints with CRP measure score [DAS28-CRP], and RA disease activity index [RADAI]), modified health assessment questionnaire (mHAQ), quality of life (EuroQOL five dimensions questionnaire [EQ5D]) and patient satisfaction (nine-item visit-specific satisfaction questionnaire [VSQ9]). RESULTS: Of 85 participants, 54 were randomized to the video-conferencing team model and 31 to the traditional clinic (control group). Dropout rates were high, with only 31 (57%) from the video-conferencing and 23 (74%) from the control group completing the study. The mean age for study participants was 56 years; 20% were male. Mean RA disease duration was 13.9 years. There were no significant between-group differences in DAS28-CRP, RADAI, mHAQ or EQ5D scores at baseline or over the study period. Satisfaction rates were high in both groups. CONCLUSIONS: We found no evidence of a difference in effectiveness between inter-professional video-conferencing and traditional rheumatology clinic for both the provision of effective follow-up care and patient satisfaction for established RApatients. High dropout rates reinforce the need for consultation with patients' needs and preferences in developing models of care. While use of video-conferencing/telehealth technologies may be a distinct advantage for some patients, there may be loss of travel-related auxiliary benefits for others.
Authors: Daniela C Gonçalves-Bradley; Ana Rita J Maria; Ignacio Ricci-Cabello; Gemma Villanueva; Marita S Fønhus; Claire Glenton; Simon Lewin; Nicholas Henschke; Brian S Buckley; Garrett L Mehl; Tigest Tamrat; Sasha Shepperd Journal: Cochrane Database Syst Rev Date: 2020-08-18
Authors: Kerstin A Kessel; Marco M E Vogel; Carmen Kessel; Henning Bier; Tilo Biedermann; Helmut Friess; Peter Herschbach; Rüdiger von Eisenhart-Rothe; Bernhard Meyer; Marion Kiechle; Ulrich Keller; Christian Peschel; Florian Bassermann; Roland Schmid; Markus Schwaiger; Stephanie E Combs Journal: Clin Transl Radiat Oncol Date: 2018-10-04
Authors: P Aries; M Welcker; J Callhoff; G Chehab; M Krusche; M Schneider; C Specker; J G Richter Journal: Z Rheumatol Date: 2020-11-17 Impact factor: 1.372
Authors: Felix Muehlensiepen; Johannes Knitza; Wenke Marquardt; Jennifer Engler; Axel Hueber; Martin Welcker Journal: J Med Internet Res Date: 2021-03-29 Impact factor: 5.428