The landscape of healthcare delivery has been drastically changed by the recent COVID-19 pandemic, prompting a shift towards remote monitoring and telemedicine. During a late-breaking abstract session at the European Alliance of Associations for Rheumatology (EULAR) annual meeting, Dr. Inger Jorid Berg presented findings from a randomized trial that evaluated different approaches to follow-up care for axial spondyloarthritis (axSpA) patients.
Study Design
The randomized trial, known as ReMonit, included 243 axSpA patients in Norway who were assigned to one of three follow-up care types: usual care with prescheduled in-person visits every 6 months, remote monitoring and consultation via video, or patient-initiated care where patients were encouraged to initiate follow-up contact with clinic staff.
The primary endpoint of the study was the probability of achieving an Axial Spondyloarthritis Disease Activity Index (ASDAS) score less than 2.1 at 6, 12, and 18 months. The study found that there were no substantial differences between the three groups, with 92%-96% of patients in all groups showing ASDAS scores below the threshold. Patient satisfaction was high across all groups, with only about 5% of patients in usual care and remote monitoring expressing dissatisfaction, compared to 1% in patient-initiated care.
Resource use was measured as a composite of direct and indirect costs associated with healthcare visits and contacts. The study found that resource use was nearly 10 times greater with usual care than with remote monitoring or patient-initiated care, with the excess associated with usual care stemming from regularly scheduled in-person visits. Additionally, remote monitoring was found to be more intensive for short contacts by phone compared to the other two forms of care.
The results of this study suggest that remote monitoring and patient-initiated care may be effective alternatives to traditional in-person follow-up care for axSpA patients. Not only were patients in these groups medically non-inferior, but resource utilization was also significantly lower. This shift towards remote care may allow for more targeted and efficient use of healthcare resources, ultimately benefiting both patients and healthcare systems.
The study conducted by Dr. Inger Jorid Berg and colleagues provides valuable insights into the potential benefits of remote monitoring and patient-initiated care for axSpA patients. As the healthcare landscape continues to evolve, it is crucial to explore innovative approaches to delivering care that prioritize patient outcomes and resource efficiency. This study paves the way for future research and implementation of remote care strategies in the management of chronic conditions like axSpA.
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