Combination of Virtual and In-Clinic Appointments Most Preferable for PsA

Patients whose symptoms are well controlled and who have an established relationship with their health care provider appear most satisfied with telemedicine appointments for psoriatic arthritis (PsA), according to a study published online in BMC Rheumatology.

“Respondents were often less concerned about telemedicine if they had established relationships with the health professional that they were talking to,” reported a UK-based research team. “A recurring view was that patients newly diagnosed should have in-clinic appointments to build rapport and get control of their symptoms.”

The study was based on results from an 18-question e-survey developed by 2 patient representatives on the British Psoriatic Arthritis Consortium steering committee. The survey was distributed in January 2021 by several patient organizations and support networks in the United Kingdom.

Overall, 128 patients responded. Most telemedicine appointments were with a rheumatologist or a rheumatology nurse, although virtual physical therapy, occupational therapy, and general practitioner PsA-related appointments also occurred.

Among 109 patients who rated the effectiveness of their telemedicine PsA-related appointment, 63% said it was as or more effective than an in-clinic consultation, 28% said it was not as effective as in-clinic assessment, and 8% said it was not at all effective, according to the study.

As to whether telemedicine appointments would benefit patients after the pandemic, 48% said yes, 26% said no, and 26% were not sure. Half of the patients felt they could be more open during an in-clinic appointment, although 6 patients said they could be more open in a telemedicine appointment.

Open-ended questions revealed several themes regarding the pitfalls of telemedicine appointments: lack of visual cues, lack of physical examination, and effect on rapport.

“Although there are many benefits to virtual consultations, limitations according to patients with active symptoms of disease include the limited ability for a physical examination,” researchers wrote. “As such, although many patients are aware telemedicine is likely to be the ‘new norm’ to some extent indefinitely, a hybrid model of virtual as well as in-clinic reviews, with the possibility of seeing a health care professional in-person in the case of a flare, is the most preferable model of health care delivery.”

—Jolynn Tumolo

Reference:
Jethwa H, Brooke M, Parkinson A, Dures E, Gullick NJ. Patients’ perspectives of telemedicine appointments for psoriatic arthritis during the COVID-19 pandemic: results of a patient-driven pilot survey. BMC Rheumatol. 2022;6(1):13.