SP0133 Patient experiences from a tele-health intervention on disease activity in ra: the keen and the reluctant patient
Authors: L.R. Knudsen
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Recently, the effectiveness of monitoring disease activity in rheumatoid arthritis (RA) through a patient-reported outcome (PRO)-based tele-health follow-up strategy was compared to usual outpatient follow-up in the TeRA trial.<sup><sup>1</sup></sup> Telemedicine interventions require patients taking an active role in the disease course and treatment, and assuming more responsibility for monitoring and identifying signs and symptoms of disease activity.<sup><sup>2–3</sup></sup> The TeRA study examines the effectiveness of tele-health follow-up, but provides no insight into how patients experience this new approach to disease control. <h3>Objectives</h3> To explore the experiences of a PRO-based tele-health follow-up from the perspective of patients with RA and their experiences of increasing their active role and responsibility for disease control in particular. <h3>Methods</h3> Adopting a strategy of <i>interpretive description</i>,<sup><sup>4</sup></sup> we conducted individual, semi-structured interviews with 15 RA patients participating in the tele-health follow-up. Participants were selected purposively and consecutive from both genders and with various ages, disease durations and disease severity. The analysis was inductive with a constant comparative approach. First, we identified the main themes conveying the participants' experiences. Then, we constructed patient typologies to explain different perspectives on the tele-health follow-up. <h3>Results</h3> Five themes covered the participants' experiences: 'A flexible solution', 'Responsibility','Knowledge of RA', 'Communication and involvement' and 'Continuity'. Two typologies: 'the keen patient' and 'the reluctant patient' represented opposite perspectives and preferences regarding the core value of and approach to the tele-health follow-up. <h3>Conclusions</h3> The participants had positive perceptions of the PRO-based tele-health follow-up and saw it as a flexible and resource-saving solution that can reduce the burden of unnecessary interruptions in everyday life. They reported disadvantages related to missing face-to-face contact with health professionals. The two typologies, 'the keen' and 'the reluctant' patient, help us understand the patients' different needs, wishes and abilities to take part in tele-health follow-up. Our findings reveal a need for more insight into how tele-health follow-up could be integrated in routine clinical practice, paying special attention to how reluctant patients may be supported. <h3>References</h3> [1] Thurah A, Stengaard-Pedersen K, Axelsen M, Fredberg U, Schougaard LMV, Hjollund NHI, et al. A tele-health follow-up strategy for tight control of disease activity in rheumatoid arthritis: results of the non-inferiority randomised controlled trial (the TeRA study). Arthritis Care Res2017 [Epub ahead of print]. [2] Wildevuur SE, Simonse LW. Information and communication technology-enabled person-centred care for the "big five" chronic conditions: Scoping review. J Med Internet Res2015;17:77. [3] Paré G, Mogadem K, Pineau G, St-Hilaire C. Clinical effects of home telemonitoring in the context of diabetes, asthma, heart failure and hypertension: A systematic review. J Med Internet Res2010;12:21. [4] Thorne S. <i>Interpretive description: Qualitative Research for Applied Practice</i>. New York and London: Routledge; 2016 (2nd ed.). <h3>Disclosure of Interest</h3> None declared