Table 1

EULAR points to consider for the use of remote care in people with RMD

Overarching principles	LoE	LoA*
A. Tailored care combining remote and face-to-face attendance should be based on shared decision-making as well as the needs and preferences of people with RMD.	n.a.	9.7 (0.7) 96.6%>8
B. Remote care† for people with RMD can be delivered by all members of the healthcare team using a variety of telehealth techniques.	n.a.	9.1 (1.3) 86.2%>8
C. Telehealth‡ interventions should be developed in collaboration with all stakeholders including the healthcare team, caregivers and people with RMD.	n.a.	9.7 (0.7) 100%>8
D. Members of the healthcare team involved in remote care interventions should have adequate equipment and training, as well as telecommunication skills.	n.a	9.7 (0.7) 96.6%>8
Specific points to consider
1. Pre-assessment by telehealth may be considered to improve the referral process to rheumatology and help prioritisation of people with suspected RMD.	2b	8.5 (2.1) 82.1%>8
2. Telehealth may assist pre-diagnostic processes for RMD; however, diagnosis should be established in a face-to-face visit.	2b	8.7 (2.0) 71.4%>8
3. The decision to initiate disease-modifying drugs should be made in a face-to-face visit. Telehealth may be used for drug education, monitoring and facilitating adherence.	2b	9.1 (1.4) 89.3%>8
4. Dose modifications or suspension of disease-modifying drugs, as well as addition of analgesics, NSAIDs or glucocorticoids can be discussed with people with RMD using telehealth.	2b	9.3 (1.3) 92.9%>8
5. Telehealth can be used to monitor symptoms, disease activity and other outcomes.	2b	9.6 (0.8) 96.4%>8
6. Telehealth may be used to discuss the need for a face-to-face consultation or other interventions.	2b	9.8 (0.7) 96.4%>8
7. Telehealth should be considered for non-pharmacological interventions including, but not limited to, disease education, advice on physical activity and exercise, self-management strategies and psychological treatment.	2b	9.4 (1.1) 92.9%>8
8. Barriers to remote care should be evaluated and resolved wherever possible.	5	9.7 (0.8) 96.4%>8
9. People with RMD using remote care should be offered training in using telehealth.	5	9.5 (1.0) 96.4%>8

*LoA, level of agreement (mean (SD)).
†Remote care: the provision of care using telehealth and virtual technology allowing patients to be evaluated, monitored and possibly treated while the patient and HCP are physically remote from each other.
‡Telehealth: the use of telecommunications and virtual technology to deliver healthcare outside of traditional healthcare facilities.
HCP, healthcare provider; LoA, level of agreement; LoE, level of evidence; NSAIDs, nonsteroidal anti-inflammatory drugs; RMD, rheumatic and musculoskeletal disease.