Digitally-supported patient-centered asynchronous outpatient follow-up in rheumatoid arthritis - an explorative qualitative study
Abstract Objective A steadily increasing demand and decreasing number of rheumatologists push current rheumatology care to its limits. Long travel times and poor accessibility of rheumatologists present particular challenges for patients. Need-adapted, digitally supported, patient-centered and flexi...
| Main Authors: | , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-10-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12913-022-08619-6 |
| _version_ | 1811335038277517312 |
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| author | Ramona Stenzel Katharina Hadaschik Susann May Manuel Grahammer Hannah Labinsky Martin Welcker Johannes Hornig Gerlinde Bendzuck Corinna Elling-Audersch Ulrike Erstling Patricia Steffens Korbanka Nicolas Vuillerme Martin Heinze Gerhard Krönke Georg Schett Ann-Christin Pecher Martin Krusche Johanna Mucke Johannes Knitza Felix Muehlensiepen |
| author_facet | Ramona Stenzel Katharina Hadaschik Susann May Manuel Grahammer Hannah Labinsky Martin Welcker Johannes Hornig Gerlinde Bendzuck Corinna Elling-Audersch Ulrike Erstling Patricia Steffens Korbanka Nicolas Vuillerme Martin Heinze Gerhard Krönke Georg Schett Ann-Christin Pecher Martin Krusche Johanna Mucke Johannes Knitza Felix Muehlensiepen |
| author_sort | Ramona Stenzel |
| collection | DOAJ |
| description | Abstract Objective A steadily increasing demand and decreasing number of rheumatologists push current rheumatology care to its limits. Long travel times and poor accessibility of rheumatologists present particular challenges for patients. Need-adapted, digitally supported, patient-centered and flexible models of care could contribute to maintaining high-quality patient care. This qualitative study was embedded in a randomized controlled trial (TELERA) investigating a new model of care consisting of the use of a medical app for ePRO (electronic patient-reported outcomes), a self-administered CRP (C-reactive protein) test, and joint self-examination in rheumatoid arthritis (RA) patients. The qualitative study aimed to explore experiences of RA patients and rheumatology staff regarding (1) current care and (2) the new care model. Methods The study included qualitative interviews with RA patients (n = 15), a focus group with patient representatives (n = 1), rheumatology nurses (n = 2), ambulatory rheumatologists (n = 2) and hospital-based rheumatologists (n = 3). Data was analyzed by qualitative content analysis. Results Participants described current follow-up care as burdensome. Patients in remission have to travel long distances. Despite pre-scheduled visits physicians lack questionnaire results and laboratory results to make informed shared decisions during face-to-face visits. Patients reported that using all study components (medical app for ePRO, self-performed CRP test and joint self-examination) was easy and helped them to better assess their disease condition. Parts of the validated questionnaire used in the trial (routine assessment of patient index data 3; RAPID3) seemed outdated or not clear enough for many patients. Patients wanted to be automatically contacted in case of abnormalities or at least have an app feature to request a call-back or chat. Financial and psychological barriers were identified among rheumatologists preventing them to stop automatically scheduling new appointments for patients in remission. Rheumatology nurses pointed to the potential lack of personal contact, which may limit the holistic care of RA-patients. Conclusion The new care model enables more patient autonomy, allowing patients more control and flexibility at the same time. All components were well accepted and easy to carry out for patients. To ensure success, the model needs to be more responsive and allow seamless integration of education material. Trial registration The study was prospectively registered on 2021/04/09 at the German Registry for Clinical Trials (DRKS00024928). |
| first_indexed | 2024-04-13T17:18:03Z |
| format | Article |
| id | doaj.art-f1dbdae1a4904346b668e20dc2054b6e |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-04-13T17:18:03Z |
| publishDate | 2022-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-f1dbdae1a4904346b668e20dc2054b6e2022-12-22T02:38:04ZengBMCBMC Health Services Research1472-69632022-10-0122111210.1186/s12913-022-08619-6Digitally-supported patient-centered asynchronous outpatient follow-up in rheumatoid arthritis - an explorative qualitative studyRamona Stenzel0Katharina Hadaschik1Susann May2Manuel Grahammer3Hannah Labinsky4Martin Welcker5Johannes Hornig6Gerlinde Bendzuck7Corinna Elling-Audersch8Ulrike Erstling9Patricia Steffens Korbanka10Nicolas Vuillerme11Martin Heinze12Gerhard Krönke13Georg Schett14Ann-Christin Pecher15Martin Krusche16Johanna Mucke17Johannes Knitza18Felix Muehlensiepen19Department of Internal Medicine 3, Rheumatology and Immunology Friedrich Alexander University Erlangen-Nürnberg and Universitätsklinikum ErlangenCenter for Health Services Research, Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor FontaneCenter for Health Services Research, Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor FontaneCenter for Health Services Research, Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor FontaneDepartment of Internal Medicine 3, Rheumatology and Immunology Friedrich Alexander University Erlangen-Nürnberg and Universitätsklinikum ErlangenMVZ für Rheumatologie Dr. Martin Welcker GmbHRheumapraxis an der HaseDeutsche Rheuma-Liga Bundesverband e.VDeutsche Rheuma-Liga Bundesverband e.VFachverband Rheumatologische Fachassistenz e. VRheumapraxis an der HaseAGEIS, Université Grenoble AlpesCenter for Health Services Research, Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor FontaneDepartment of Internal Medicine 3, Rheumatology and Immunology Friedrich Alexander University Erlangen-Nürnberg and Universitätsklinikum ErlangenDepartment of Internal Medicine 3, Rheumatology and Immunology Friedrich Alexander University Erlangen-Nürnberg and Universitätsklinikum ErlangenCentre for Interdisciplinary Clinical Immunology, Rheumatology and Autoinflammatory Diseases, University Hospital TuebingenDivision of Rheumatology and Systemic Inflammatory Diseases, University Hospital Hamburg-Eppendorf (UKE)Policlinic and Hiller Research Unit for Rheumatology, Medical Faculty, University Hospital Düsseldorf, Heinrich Heine University DüsseldorfDepartment of Internal Medicine 3, Rheumatology and Immunology Friedrich Alexander University Erlangen-Nürnberg and Universitätsklinikum ErlangenCenter for Health Services Research, Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor FontaneAbstract Objective A steadily increasing demand and decreasing number of rheumatologists push current rheumatology care to its limits. Long travel times and poor accessibility of rheumatologists present particular challenges for patients. Need-adapted, digitally supported, patient-centered and flexible models of care could contribute to maintaining high-quality patient care. This qualitative study was embedded in a randomized controlled trial (TELERA) investigating a new model of care consisting of the use of a medical app for ePRO (electronic patient-reported outcomes), a self-administered CRP (C-reactive protein) test, and joint self-examination in rheumatoid arthritis (RA) patients. The qualitative study aimed to explore experiences of RA patients and rheumatology staff regarding (1) current care and (2) the new care model. Methods The study included qualitative interviews with RA patients (n = 15), a focus group with patient representatives (n = 1), rheumatology nurses (n = 2), ambulatory rheumatologists (n = 2) and hospital-based rheumatologists (n = 3). Data was analyzed by qualitative content analysis. Results Participants described current follow-up care as burdensome. Patients in remission have to travel long distances. Despite pre-scheduled visits physicians lack questionnaire results and laboratory results to make informed shared decisions during face-to-face visits. Patients reported that using all study components (medical app for ePRO, self-performed CRP test and joint self-examination) was easy and helped them to better assess their disease condition. Parts of the validated questionnaire used in the trial (routine assessment of patient index data 3; RAPID3) seemed outdated or not clear enough for many patients. Patients wanted to be automatically contacted in case of abnormalities or at least have an app feature to request a call-back or chat. Financial and psychological barriers were identified among rheumatologists preventing them to stop automatically scheduling new appointments for patients in remission. Rheumatology nurses pointed to the potential lack of personal contact, which may limit the holistic care of RA-patients. Conclusion The new care model enables more patient autonomy, allowing patients more control and flexibility at the same time. All components were well accepted and easy to carry out for patients. To ensure success, the model needs to be more responsive and allow seamless integration of education material. Trial registration The study was prospectively registered on 2021/04/09 at the German Registry for Clinical Trials (DRKS00024928).https://doi.org/10.1186/s12913-022-08619-6TelemedicineRheumatologyUser experienceRemote careQualitative researchEmpowerment |
| spellingShingle | Ramona Stenzel Katharina Hadaschik Susann May Manuel Grahammer Hannah Labinsky Martin Welcker Johannes Hornig Gerlinde Bendzuck Corinna Elling-Audersch Ulrike Erstling Patricia Steffens Korbanka Nicolas Vuillerme Martin Heinze Gerhard Krönke Georg Schett Ann-Christin Pecher Martin Krusche Johanna Mucke Johannes Knitza Felix Muehlensiepen Digitally-supported patient-centered asynchronous outpatient follow-up in rheumatoid arthritis - an explorative qualitative study BMC Health Services Research Telemedicine Rheumatology User experience Remote care Qualitative research Empowerment |
| title | Digitally-supported patient-centered asynchronous outpatient follow-up in rheumatoid arthritis - an explorative qualitative study |
| title_full | Digitally-supported patient-centered asynchronous outpatient follow-up in rheumatoid arthritis - an explorative qualitative study |
| title_fullStr | Digitally-supported patient-centered asynchronous outpatient follow-up in rheumatoid arthritis - an explorative qualitative study |
| title_full_unstemmed | Digitally-supported patient-centered asynchronous outpatient follow-up in rheumatoid arthritis - an explorative qualitative study |
| title_short | Digitally-supported patient-centered asynchronous outpatient follow-up in rheumatoid arthritis - an explorative qualitative study |
| title_sort | digitally supported patient centered asynchronous outpatient follow up in rheumatoid arthritis an explorative qualitative study |
| topic | Telemedicine Rheumatology User experience Remote care Qualitative research Empowerment |
| url | https://doi.org/10.1186/s12913-022-08619-6 |
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