Background Telemedicine is frequently used in the treatment of patients with different chronic diseases. Telemedical solutions have proven effective, time-saving and associated with patient satisfaction (1). However, no studies have explored the effect of telemedical interventions in patients with rheumatoid arthritis (RA). Evidence is scarce on the patient perspective concerning needs for and expectations to telemedical solutions (2).
Objectives To identify necessary components of and expectations to a telemedical intervention to monitor and control disease activity in patients with RA from the perspective of health professionals and patients.
Methods Patients with RA and health professionals were interviewed in focus groups. The group of patients included three females and three males aged 24 – 73 years with disease duration from three months to 40 years. The group of health professionals included six females and one male. The group consisted of three doctors and four nurses with a minimum of three years experience in rheumatology.
The focus group discussions were taped and transcribed verbatim. Data were analysed in accordance with Kvale & Brinkmann including coding, condensation and interpretation of meaning (3).
Results The analysis of the interview with patients resulted in nine central themes: “Outpatient consultation versus consultation by telephone”, “Qualifications”, “Structure and individualisation”, “Preparation”, “Communication”, “Continuity”, “Responsibility of patient”, “Confidence versus uncertainty of IT technology”, “Time, socially and economically efficient”.
The analysis of the interview with health professionals resulted in eight central themes: “Outpatient consultation versus consultation by telephone”, “Qualifications”, “Experience of rheumatology”, “Structure and continuity”, “Responsibility of patient”, “Matching of expectations”, “Physical environment and organising”, “Time-saving”.
Conclusions According to this study patients and health professionals agreed on what was necessary in telemedical interventions. Newly diagnosed patients are not candidates for telemedical interventions. Health professionals must be experienced in rheumatology care. Telemedical interventions must be structured from time to time and both patients and health professionals must be prepared. This study showed that it is not important whether telephone consultations are conducted by a doctor or a nurse. Patients highlighted that health professionals must be aware of how to communicate by phone to ensure that problems are not missed. Moreover, not all patients are familiar with the use of technology. The health professionals emphasised that there must be a matching of expectations, so patients are well informed about what to expect. In addition, thephysical environment must support the use of telemedical interventions.
Pare G., Jaana M., Sicotte C. Systematic review of home telemonitorering for chronic disease. the evidence base. J Am Med Inform Assoc 2007 May-Jun; 14(3):269-277
van Eijk-Hustings Y., van Tubergen A,. Bostrom C., Braychenko E., Buss B., felix J., et al. Eular recommendations for the role of the nurse in the management of chronic inflammatory arthritis. Ann Rheum Dis 2012 J;71(1):13-19
Kvale S. & Brinkmann S. Interview. Hans Reitzels Forlag 2009
Disclosure of Interest : None declared
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