Embracing Telehealth: What to Consider in Arthritis and Rheumatic Diseases
Telehealth quickly gained popularity during the COVID-19 pandemic but continues to be a vital tool for managing chronic conditions like arthritis and rheumatic diseases. For young adults juggling busy lives, telehealth offers a convenient way to access care. Researchers are trying to learn more about the pros and cons of virtual rheumatology visits and how to use telehealth for the right patients to allow the best care possible (1). Some rheumatology associations, such as the Canadian Rheumatology Association, have even published guiding principles to help rheumatologists use telehealth more effectively (2).
Advantages of Telehealth
Telehealth has some fantastic perks. One of the biggest benefits is the sheer convenience of it all. Imagine having your doctor’s appointment without leaving the comfort of your own home. No stressing about commuting or sitting in waiting rooms. This can be particularly helpful if you have limited mobility or live far from your rheumatologist.
A major strength of telehealth includes the excellent satisfaction ratings by rheumatology patients which was replicated in several studies (3). The highest levels of satisfaction were found in young adults and patients in younger age groups (1). This may be due to younger generations being more familiar with technology.
Telehealth is highly advantageous in bridging the gap for patients who live in areas with limited access to a rheumatologist; it also works well for routine follow-up visits and discussing test results (2). Interestingly, virtual examination for joint range of motion is not only possible with telehealth but has also been shown to be quite effective (4). This allows telehealth to be a reasonable option for follow-up in patients with a diagnosis of inflammatory arthritis (2).
Barriers to Telehealth
Despite the benefits, telehealth isn’t perfect. One big hurdle is the dependence on technology. Not everyone has a reliable internet connection or the right devices to make a video call. If tech isn’t your strong suit, setting up and navigating telehealth platforms can be a bit tricky (2). Another consideration is how language and health literacy can pose challenges. If there’s a language barrier or you find medical jargon confusing, it can sometimes be harder to communicate effectively during a virtual visit (1).
Rheumatologists rely on hands-on physical exams to check for joint swelling and tenderness. Without this, it is tougher for rheumatologists to gauge your condition accurately. This makes doctors less likely to feel satisfied with telehealth (4) and it can also make your rheumatologist less likely to recommend changes in treatment during a telehealth visit (1). This isn’t an issue if it is obvious that you are doing well, such as being in remission or having an obvious flare of disease. However, telehealth might not be helpful when trying to figure out if symptoms are due to active inflammatory disease or non-inflammatory causes.
General Tips Regarding Telehealth
To make the most of your telehealth appointments, preparation is key. Here are some tips to help you get started:
Ensure Reliable Technology: Make sure your internet is stable, and your device is charged and ready to go. Get familiar with the telehealth platform beforehand to avoid any tech hiccups during your appointment.
Prepare Your Space: Find a quiet, well-lit spot for your appointment. Your rheumatologist might need to assess your joints which means there should be enough space for you to walk around and fully stretch out your arms and legs.
Have Your Information Ready: Keep a list of your current medications, any symptoms you’re experiencing, and questions you want to ask. This way, you’ll cover everything important without forgetting anything in the moment.
Understand the Limitations: Remember, it can be tough for your rheumatologist to fully assess your condition without a physical exam. If you are hoping to discuss medication changes or feel like your disease activity isn’t well-controlled, consider asking for an in-person visit, if possible.
Follow-up: After your telehealth visit, make sure to follow any instructions your doctor discussed with you. If you have further questions or concerns, don’t hesitate to reach out – good communication is key to effective care.
Telehealth is a promising tool for managing arthritis and rheumatic diseases. While there are some hurdles to navigate, being prepared and understanding the limitations can help you get the most out of your virtual visits. Similarly, healthcare providers are also learning how to better utilize telehealth in rheumatology care. By learning to embrace telehealth, we can take advantage of the accessibility and flexibility it can offer.
1. Venuturupalli, S. et al. Home-Based Telemedicine in Rheumatology—A Scoping Review. ACR Open Rheumatology vol. 6 312–320 at https://doi.org/10.1002/acr2.11660 (2024).
2. Barber, C. E. H. et al. Best Practices for Virtual Care: A Consensus Statement From the Canadian Rheumatology Association. Journal of Rheumatology 49, 408–418 (2022).
3. Jackson, L. E. et al. Telemedicine in rheumatology care: A systematic review. Seminars in arthritis and rheumatism 56, 152045 (2022).
4. Giray, E., Kenis-Coskun, O., Karadag-Saygi, E. & Ozyemisci-Taskiran, O. Interrater Reliability, Acceptability, and Practicality of Real-Time Video Pediatric Gait, Arms, Legs, and Spine for Musculoskeletal Assessment of Children during Telemedicine Visits. Journal of Clinical Rheumatology 28, 235–239 (2022).
5. Howe, C. et al. Evaluating Provider Perceptions of Telehealth Utility in Outpatient Rheumatology Telehealth Encounters. Journal of Clinical Rheumatology 30, 46–51 (2024).
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