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An evaluation of the Virtual Monitoring Clinic, a novel nurse‐led service for monitoring patients with stable rheumatoid arthritis
Author(s) -
Chew LiChing,
Xin Xiaohui,
Yang Hui,
Thumboo Julian
Publication year - 2019
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/1756-185x.13436
Subject(s) - medicine , rheumatoid arthritis , rheumatology , outpatient clinic , physical therapy , patient satisfaction , surgery
Objectives To study clinical and patient reported outcomes for the Virtual Monitoring Clinic (VMC), a remote nurse‐led telemonitoring service for monitoring Rheumatoid Arthritis (RA) patients treated with disease‐modifying antirheumatic drugs (DMARDs). Methods Patients with stable RA enrolled in the VMC were followed up prospectively. The primary outcomes evaluated at 1‐year follow‐up were: Disease Activity Score‐28 (DAS28), Routine Assessment of Patient Index Data 3 (RAPID3), and patient satisfaction assessed using an 11‐point Likert scale. Results Of the 251 patients enrolled, 186 completed 1‐year of follow‐up. There was a 2.3% (n = 450) reduction in the annual workload from the rheumatology specialist outpatient clinic as a result of the VMC. Statistically significant improvement was seen in the mean patient satisfaction score (7.70‐8.16, P ≤ 0.001), with 61.5% of patients opting for the VMC alternating with rheumatology outpatient clinic visits as their preferred mode of follow‐up vis‐à‐vis standard care. There was a marginal increase in mean DAS28 and RAPID3 scores from 2.56 to 2.78 ( P < 0.05) and 5.28 to 6.03 ( P < 0.05), respectively. However, given that at 1‐year follow‐up more than half (72.0% and 63.4% based on DAS28 and RAPID3) of the patients’ disease activity had improved or remained stable, and was in remission or low activity (73.1% and 53.2% based on DAS28 and RAPID3), the VMC seemed to maintain a stable RA disease activity for the majority of patients. Conclusions The VMC is an effective and well‐accepted novel approach for the management of patients with stable RA.