What Factors Are Associated With Participation in Remote Care Among Patients With RA?

Among patients with rheumatoid arthritis (RA), participation in remote follow-up was found to be associated with work and socioeconomic status, comorbidities, and confidence in remote health care, according to the results of a study published in Arthritis Care & Research.

The study was designed to evaluate predictors associated with participation in remote care among patients with RA.

The telehealth rheumatoid arthritis (TeRA) study was conducted at the Aarhus University Hospital in Denmark. In 2019, patients with RA were sent an electronic questionnaire about socioeconomic, disease-related, and demographic characteristics. Information about nonrespondents was collected through national databases. Patients were also referred to receive a remote follow-up or conventional outpatient follow-up.

A total of 775 patients were eligible to receive the questionnaire; however, 129 had no secure mailbox set up. Of the patients with a secure mailbox, 394 (61%) completed the questionnaire. Among the patients who completed the questionnaire, 158 attended a remote follow-up and 236 attended the conventional follow-up.

The respondents (n=394) and nonrespondents (n=252) were aged a median of 63.8 years and 57.9 years; 68.5% and 72.2% were women; and 19.3% and 15.5% had a Charlson Comorbidity Index (CCI) of greater than 2, respectively.

Individuals who did not respond to the questionnaire were more likely to be attached to the labor market (P =.01). Those who attended the conventional follow-up were less likely to respond to the questionnaire (P <.001).

Using data from all eligible participants, attending the remote follow-up was inversely associated with detachment from the labor market (adjusted odds ratio [aOR], 0.53; 95% CI, 0.34-0.83), a CCI score of greater than 2 (aOR, 0.53; 95% CI, 0.34-0.81), and a low household income (aOR, 0.69; 95% CI, 0.48-1.00).

Among those who completed the questionnaire, attending the remote follow-up was associated with having confidence in remote care (aOR, 1.33; 95% CI, 1.21-1.47), responding positively to the question about talking adequately to the health care provider about disease management (aOR, 1.28; 95% CI, 1.03-1.57), and feeling like their health care provider invited them to ask questions and talk about their concerns (aOR, 1.21; 95% CI, 1.00-1.46).

A major limitation of the study was the cross-sectional design, which did not allow for causal inferences to be made.

These data indicated that remote RA health participation was more likely among individuals working in the labor market, with high household income, and lower levels of comorbidities.

“A future focus should be on how to support patients with RA in conventional follow-up to achieve confidence in remote follow-up, as well as increased focus on vulnerable patient groups and the need for differential use of healthcare services,” the study authors concluded.