دورية أكاديمية
Evaluating Factors Associated With Telehealth Appropriateness in Outpatient Rheumatoid Arthritis Encounters Using the Encounter Appropriateness Score for You (EASY).
| العنوان: | Evaluating Factors Associated With Telehealth Appropriateness in Outpatient Rheumatoid Arthritis Encounters Using the Encounter Appropriateness Score for You (EASY). |
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| المؤلفون: | Smith ID; I.D. Smith, MD, MSc, C. Sims, MD, Department of Medicine, Division of Rheumatology and Immunology, Duke University School of Medicine, and Department of Medicine, Division of Rheumatology, Durham Veterans Affairs Medical Center; isaac.smith063@duke.edu., Solomon MJ; M.J. Solomon, MS, AI Health, Duke University School of Medicine, and Department of Biostatistics and Bioinformatics, Duke University School of Medicine., Mulder H; H. Mulder, MS, R. Overton, MS, R. Zhao, B. Adagarla, MS, Duke Clinical Research Institute, Duke University School of Medicine., Sims C; I.D. Smith, MD, MSc, C. Sims, MD, Department of Medicine, Division of Rheumatology and Immunology, Duke University School of Medicine, and Department of Medicine, Division of Rheumatology, Durham Veterans Affairs Medical Center., Coles TM; T.M. Coles, PhD, Department of Population Health Sciences, Duke University School of Medicine., Overton R; H. Mulder, MS, R. Overton, MS, R. Zhao, B. Adagarla, MS, Duke Clinical Research Institute, Duke University School of Medicine., Economou-Zavlanos N; N. Economou-Zavlanos, PhD, AI Health, Duke University School of Medicine, and Office of Academic Solutions and Information Systems, Duke Health Technology Solutions, Duke Health., Zhao R; H. Mulder, MS, R. Overton, MS, R. Zhao, B. Adagarla, MS, Duke Clinical Research Institute, Duke University School of Medicine., Adagarla B; H. Mulder, MS, R. Overton, MS, R. Zhao, B. Adagarla, MS, Duke Clinical Research Institute, Duke University School of Medicine., Doss J; J. Doss, MD, MPH, M.E.B. Clowse, MD, MPH, D.L. Leverenz, MD, MEd, Department of Medicine, Division of Rheumatology and Immunology, Duke University School of Medicine., Henao R; R. Henao, PhD, Department of Biostatistics and Bioinformatics, Duke University School of Medicine, and Duke Clinical Research Institute, Duke University School of Medicine., Clowse MEB; J. Doss, MD, MPH, M.E.B. Clowse, MD, MPH, D.L. Leverenz, MD, MEd, Department of Medicine, Division of Rheumatology and Immunology, Duke University School of Medicine., Bosworth H; H. Bosworth, PhD, Department of Population Health Sciences, Duke University School of Medicine, and Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Medical Center, and Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, and Duke University School of Nursing, Durham, North Carolina, USA., Leverenz DL; J. Doss, MD, MPH, M.E.B. Clowse, MD, MPH, D.L. Leverenz, MD, MEd, Department of Medicine, Division of Rheumatology and Immunology, Duke University School of Medicine. |
| المصدر: | The Journal of rheumatology [J Rheumatol] 2024 Aug 01; Vol. 51 (8), pp. 759-764. Date of Electronic Publication: 2024 Aug 01. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Journal Of Rheumatology Publishing Co Country of Publication: Canada NLM ID: 7501984 Publication Model: Electronic Cited Medium: Internet ISSN: 1499-2752 (Electronic) Linking ISSN: 0315162X NLM ISO Abbreviation: J Rheumatol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Toronto : Journal Of Rheumatology Publishing Co Original Publication: Toronto. |
| مواضيع طبية MeSH: | Arthritis, Rheumatoid*/therapy , Telemedicine*, Humans ; Female ; Male ; Middle Aged ; Prospective Studies ; Aged ; Adult ; Outpatients ; Rheumatology ; Electronic Health Records ; Ambulatory Care |
| مستخلص: | Objective: Telehealth has been proposed as a safe and effective alternative to in-person care for rheumatoid arthritis (RA). The purpose of this study was to evaluate factors associated with telehealth appropriateness in outpatient RA encounters. Methods: A prospective cohort study (January 1, 2021, to August 31, 2021) was conducted using electronic health record data from outpatient RA encounters in a single academic rheumatology practice. Rheumatology providers rated the telehealth appropriateness of their own encounters using the Encounter Appropriateness Score for You (EASY) immediately following each encounter. Robust Poisson regression with generalized estimating equations modeling was used to evaluate the association of telehealth appropriateness with patient demographics, RA clinical characteristics, comorbid noninflammatory causes of joint pain, previous and current encounter characteristics, and provider characteristics. Results: During the study period, 1823 outpatient encounters with 1177 unique patients with RA received an EASY score from 25 rheumatology providers. In the final multivariate model, factors associated with increased telehealth appropriateness included higher average provider preference for telehealth in prior encounters (relative risk [RR] 1.26, 95% CI 1.21-1.31), telehealth as the current encounter modality (RR 2.27, 95% CI 1.95-2.64), and increased patient age (RR 1.05, 95% CI 1.01-1.09). Factors associated with decreased telehealth appropriateness included moderate (RR 0.81, 95% CI 0.68-0.96) and high (RR 0.57, 95% CI 0.46-0.70) RA disease activity and if the previous encounters were conducted by telehealth (RR 0.83, 95% CI 0.73-0.95). Conclusion: In this study, telehealth appropriateness was most associated with provider preference, the current and previous encounter modality, and RA disease activity. Other factors like patient demographics, RA medications, and comorbid noninflammatory causes of joint pain were not associated with telehealth appropriateness. (Copyright © 2024 by the Journal of Rheumatology.) |
| فهرسة مساهمة: | Keywords: access to health care; rheumatoid arthritis; telemedicine |
| تواريخ الأحداث: | Date Created: 20240515 Date Completed: 20240801 Latest Revision: 20240801 |
| رمز التحديث: | 20240802 |
| DOI: | 10.3899/jrheum.2024-0014 |
| PMID: | 38749564 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1499-2752 |
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| DOI: | 10.3899/jrheum.2024-0014 |