Tele-rheumatology for Rheumatic Diseases

Overseen By Maria I Danila, MD, MsC

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Alabama at Birmingham

Must be taking: Immunosuppressive drugs

Disqualifiers: Unstable rheumatic disease, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 2

Duration: 1-2 weeks

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how virtual doctor visits (tele-rheumatology) compare to traditional in-person visits for individuals with rheumatic diseases, such as rheumatoid arthritis or lupus, who are taking immunosuppressive drugs. The researchers aim to determine if online visits can be equally effective, particularly for those more vulnerable to COVID-19 or who have difficulty accessing in-person care. Participants will be divided into two groups: one will start with a traditional visit followed by an online one, while the other will do the opposite. The trial seeks individuals with stable rheumatic disease who can access a phone for online appointments. As an unphased trial, it offers patients the chance to contribute to innovative research that could enhance access to care for those with rheumatic diseases.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It seems to focus on comparing tele-rheumatology visits with in-person care, so it's best to ask the trial organizers for more details.

What prior data suggests that tele-rheumatology is safe for people with rheumatic and musculoskeletal diseases?

Studies have shown that tele-rheumatology, which uses technology to care for joint and muscle diseases, is safe. Early research suggests it effectively manages these conditions without major safety issues. In one study, all 15 patients found tele-rheumatology helpful, particularly for maintaining contact with their doctors after starting or changing treatments. Although more detailed comparisons with regular in-person visits are needed, current evidence indicates that patients handle tele-rheumatology well. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about tele-rheumatology for managing rheumatic diseases because it offers a unique approach by leveraging technology to deliver care remotely. Unlike traditional in-person visits, tele-rheumatology allows patients to consult with their rheumatologists from the comfort of their homes, which can significantly enhance accessibility and convenience. This is particularly beneficial for patients living in remote areas or those with mobility challenges. Additionally, tele-rheumatology can lead to more frequent monitoring and potentially faster adjustments to treatment plans, thereby improving overall disease management.

What evidence suggests that tele-rheumatology is effective for rheumatic diseases?

This trial will compare tele-rheumatology (TR) with usual care for managing rheumatic diseases. Studies have shown that TR, which provides healthcare for rheumatic diseases via phone or internet, can be effective. Research indicates that patients are very satisfied with TR visits and experience health outcomes similar to in-person care. A review of several studies has found that TR helps maintain quality of life and manage symptoms well. One study showed that 98% of virtual visits were successful, suggesting TR is a good alternative to face-to-face appointments. Although more information is needed for a complete comparison, early findings suggest TR is a promising option for managing rheumatic diseases, especially during times like the COVID-19 pandemic. ^{2 3 4 6 7}

Are You a Good Fit for This Trial?

This trial is for people with rheumatic diseases like rheumatoid arthritis or lupus who are stable enough to not require in-person visits. It's especially aimed at those using immunosuppressive drugs and from socially vulnerable populations. However, it excludes individuals with unstable conditions needing face-to-face care or those without access to a phone.

Inclusion Criteria

I have been diagnosed with a rheumatic disease like rheumatoid arthritis.

Exclusion Criteria

I am expected to undergo procedures like joint injections in the doctor's office.

I have a severe rheumatic condition requiring frequent doctor visits.

Lack of access to phone

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive either a usual care visit or a tele-rheumatology visit, followed by the alternate type of visit

1-2 weeks

2 visits (1 in-person, 1 virtual)

Follow-up

Participants are monitored for patient satisfaction and preference post visits

1 week

What Are the Treatments Tested in This Trial?

Interventions

• Tele-rheumatology

Trial Overview

The study is testing the effectiveness of tele-rheumatology (remote medical consultations via phone or internet) compared to usual in-person care for patients with rheumatic diseases during the COVID-19 crisis. It's a randomized experiment aiming to provide safe and equitable care.

How Is the Trial Designed?

Group I: Usual Care first visit and Tele-rheumatology second visit Experimental Treatment 1 Intervention

Participants randomized to this visit will receive a usual care visit first.

Group II: Tele-rheumatology first visit and Usual Care second visit Experimental Treatment 1 Intervention

Participants randomized to this visit will receive a tele-rheumatology visit first.

Who Is Running the Clinical Trial?

University of Alabama at Birmingham

Lead Sponsor

Trials

1,677

Recruited

2,458,000+

Rheumatology Research Foundation

Collaborator

Trials

14

Recruited

8,200+

University of California, San Francisco

Collaborator

Trials

2,636

Recruited

19,080,000+

Tulane University

Collaborator

Trials

129

Recruited

259,000+

Citations

1.

pubmed.ncbi.nlm.nih.gov

pubmed.ncbi.nlm.nih.gov/35843158/

Telemedicine in rheumatology care: A systematic review

We included studies of telemedicine that reported outcomes (e.g., satisfaction, disease activity, quality of life) in ten or more people with rheumatic disease.

2.

sciencedirect.com

sciencedirect.com/science/article/abs/pii/S0049017222000968

Telemedicine in rheumatology care: A systematic review

We included studies of telemedicine that reported outcomes (e.g., satisfaction, disease activity, quality of life) in ten or more people with rheumatic disease.

3.

clinicaltrials.gov

clinicaltrials.gov/study/NCT04704544

Effectiveness of Tele-rheumatology for Delivering High ...

While tele-rheumatology (TR) visits are a COVID-19 related necessity, there is a lack of rigorous data on the comparative effectiveness of TR versus (vs) ...

4.

jrheum.org

jrheum.org/content/51/9/913

Telerheumatology Shared-Care Model: Leveraging the ...

Results Data from 124 patients seen between January 2013 and January 2022 were collected; 98% (n = 494/504 visits) were virtual. The average age ...

5.

academic.oup.com

academic.oup.com/mr/advance-article/doi/10.1093/mr/roaf012/8010901

Telemedicine as an alternative to in-person care in the field of ...

This systematic scoping review evaluated the effectiveness, cost-efficiency, and challenges of telemedicine for patients with rheumatic diseases.

6.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC8935581/

Future challenges in rheumatology – is telemedicine the ...

Telehealth is already being used to monitor patients with rheumatic diseases and initial studies show good results in terms of safety and disease progression.

7.

ard.bmj.com

ard.bmj.com/content/82/Suppl_1/2114.1

AB1761-HPR A TELE-MONITORING PROGRAM FOR ...

15/15 patients found the program useful, mainly for staying in contact with their rheumatologist after therapy start or switch. 13/15 patients measured their ...