Remote follow-up could be feasible for patients with RA
medwireNews: Results of a randomized trial suggest that rheumatoid arthritis (RA) patients with low disease activity who receive telephone-based follow-up achieve similar disease control to those receiving conventional outpatient follow-up.
In the TeRA study, patients with RA and a disease duration of at least 2 years were randomly assigned to receive a patient-reported outcome (PRO)-based telehealth intervention, consisting of a telephone consultation with either a rheumatologist or a nurse every 3–4 months (PRO-TR and PRO-TN groups, respectively), or usual follow-up with outpatient physician visits every 3–4 months.
Over 1 year of follow-up, the 93 participants in the PRO-TR group experienced a mean decrease in their Disease Activity Score at 28 joints (DAS28) of 0.16 points, while the 88 patients in the PRO-TN group experienced a 0.26-point reduction. By comparison, the reduction in DAS28 was 0.06 points for the 94 patients receiving conventional outpatient follow-up, a nonsignificant difference.
These findings suggest that “PRO-based tele-health follow-up for tight control of disease activity in RA can achieve similar disease control as conventional outpatient follow-up,” say Annette De Thurah (Aarhus University Hospital, Denmark) and study co-authors.
“The degree of disease control through tele-health follow-up does not differ between rheumatologists and rheumatology nurses,” they add.
Over the study period, participants in the rheumatologist- or nurse-led telehealth intervention groups visited the outpatient clinic less than half as often as those receiving conventional follow-up, with a mean 1.75 and 1.72 versus 4.15 visits.
Therefore, “the tele-health follow-up saves patient time and is likely to reduce health care costs,” write Thurah and colleagues in Arthritis Care & Research.
Overall, the study participants had low disease activity, with mean baseline DAS28 scores of 2.03, 2.10, and 2.07 points in the PRO-TR, PRO-TN, and conventional follow-up groups, respectively. This likely reflects “early [disease-modifying antirheumatic drug] treatment and the implementation of the treat-to-target strategy,” note the authors.
However, they caution that their findings may not be applicable to older patients or those with higher levels of disease activity.
Nevertheless, the researchers conclude that telehealth-based follow-up “could form an alternative to conventional out-patient follow-up in the future rheumatological care.”
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