The following is the summary of “Evaluation of Patients With Rheumatoid Arthritis in Teleconsultation During the First Wave of the COVID-19 Pandemic” published in the November 2022 issue of Rheumatology by Avouac, et al.
This study aimed to characterize the characteristics rheumatologists used to monitor patients with rheumatoid arthritis (RA) during teleconsultations and to identify those variables that had the greatest impact on clinician intervention. Patients with RA who received a teleconsultation between March 2020 and September 2020 will be included in a retrospective, single-center, cross-sectional evaluation of routine care. Teleconsultation records were mined for all available disease status characteristics. Upgrading care and/or requiring urgent in-person consultation or day hospitalization were the criteria used to indicate the necessity for clinician intervention.
Researchers enrolled 143 rheumatoid arthritis patients (116 females, mean age of 58 [SD 16] yrs, mean disease duration of 14 [SD 11] yrs). All medical records noted whether the patient had experienced a recent RA flare, the number of sensitive joints (reported by 76%), the length of morning stiffness (66%), the frequency with which discomfort kept them awake at night (66%), and the C-reactive protein (CRP) score (54%). Twenty-two of the 143 patients (15%) who received a teleconsultation were subsequently seen by a physician, which accounts for 51 percent of the patients who self-reported flares (22/43 patients).
About 13 patients required an increase in their current course of treatment, while 10 others were scheduled for either in-person consultations or day hospitalization. The clinical intervention was found to be independently related to RA flares (odds ratio [OR] 15.6, 95% CI 3.37-68.28) and CRP levels > 10 mg/L (OR 3.32, 95% CI% 1.12-13.27) in multivariate analysis. Independently related to medication adjustment and/or the necessity for a timely face-to-face consultation, our study revealed patient-reported RA flares and elevated CRP values as 2 red flags in teleconsultation. Clinical decision-making in teleconsultations may benefit from these indicators.