Table 1

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

Overarching principlesLoELoA*
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)
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)
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)
D. Members of the healthcare team involved in remote care interventions should have adequate equipment and training, as well as telecommunication skills.n.a9.7 (0.7)
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.2b8.5 (2.1)
2. Telehealth may assist pre-diagnostic processes for RMD; however, diagnosis should be established in a face-to-face visit.2b8.7 (2.0)
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.2b9.1 (1.4)
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.2b9.3 (1.3)
5. Telehealth can be used to monitor symptoms, disease activity and other outcomes.2b9.6 (0.8)
6. Telehealth may be used to discuss the need for a face-to-face consultation or other interventions.2b9.8 (0.7)
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.2b9.4 (1.1)
8. Barriers to remote care should be evaluated and resolved wherever possible.59.7 (0.8)
9. People with RMD using remote care should be offered training in using telehealth.59.5 (1.0)
  • *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.