Tailored services, shared-decision making and adequate equipment, training and communication skills are among key areas outlined in EULAR’s new points to consider for remote care in rheumatic and musculoskeletal diseases.
Compiled by a multidisciplinary EULAR task force of 30 members from 14 European countries, the guidance aims to help shape the development, prioritisation and implementation of telehealth services for people with rheumatic diseases, in the hope of improving quality of care and increasing access to healthcare.
The four overarching principles, outlined in a paper published by the BMJ’s Annals of the Rheumatic Diseases, are:
- “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;
- Remote care for people with RMD can be delivered by all members of the healthcare team using a variety of telehealth techniques;
- Telehealth interventions should be developed in collaboration with all stakeholders including the healthcare team, caregivers and people with RMD; and
- Members of the healthcare team involved in remote care interventions should have adequate equipment and training as well as telecommunication skills”
Points to consider include that telehelath could help with pre-assessment and pre-diagnostic processes for rheumatic diseases, as well as monitoring and delivering non-pharmacological interventions such as advice and education.
Also, the authors note that while initiation of DMARD therapy should always be face-to-face, telehealth could be used for drug eduction, monitoring and also for ensuring treatment adherence, and to discuss dose modifications or treatment cessation, as well as adding analgesics, NSAIDs or glucocorticoids to the treatment regimen.
Tackling barriers to access and ensuring that patients as well as staff are trained in using telehealth may also be key to successful service provision, they said.
Also, given that there is as yet limited clinical evidence on telehealth in rheumatology, the taskforce defined research priorities and potential future areas of focus to provide further certainty within the field.
These include evaluating the cost-effectiveness of telehealth interventions, exploring aspects of digital health literacy, and randomised non-inferiority and superiority trials to test the efficacy of telehealth interventions.