1. An evaluation of the Virtual Monitoring Clinic, a novel nurse‐led service for monitoring patients with stable rheumatoid arthritis.
- Author
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Chew, Li‐Ching, Xin, Xiaohui, Yang, Hui, and Thumboo, Julian
- Subjects
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RHEUMATOLOGISTS , *OUTPATIENT medical care management , *RHEUMATOID arthritis , *PATIENT monitoring , *PATIENT satisfaction , *LIKERT scale - Abstract
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. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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