POS1483-HPR THE TELEMEDICINE HETEROGENEITY IN RHEUMATIC AND MUSCULOSKELETAL DISEASES: A SCOPING REVIEW
Authors: K. El Aoufy, M. R. Melis, M. Tamburini, A. Moggi Pignone, G. Bandini, S. Bellando-Randone, M. Matucci-Cerinic, L. Rasero, S. Bambi
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> telemedicine represents an alternative approach for clinical practice while improving the standard of care. Nowadays, it is widely acknowledged for its potential in healthcare services for prevention, diagnosis, treatment, rehabilitation, and disease monitoring. These are all crucial issues to consider when dealing with chronic Rheumatic and Musculoskeletal Diseases (RMDs). During the early stages of the COVID-19 pandemic, telemedicine was widely utilized, first for necessity, then integrated to traditional approaches of care delivery. <h3>Objectives:</h3> the scoping review's objective is to determine the current state of telemedicine in the field of rheumatology, taking into account the tools and devices in use as well as the Patient Reported Outcomes included by the authors. <h3>Methods:</h3> The query of the present scoping review, conducted following the PRISMA-ScR checklist, was declined as follows: "<i>Which types of outcomes do patients with RMDs experience when exposed to digital care interventions</i>?" Five databases (MEDLINE, CINAHL, EMBASE, PsycINFO, and SCOPUS) were searched for records that met the pre-defined inclusion criteria from 1990 to 6<sup>th</sup> December 2022. Inclusion criteria were as follows: (I) adult patients with RMDs, (II) original and quantitative/qualitative/mixed method research papers in English language with available abstract, (III) telehealth and telemedicine are provided as healthcare services, (IV) specific to nursing interventions and/or outcomes. EndNote<sup>TM</sup> was used for managing references, remove duplicates and conduct eligibility screenings in line with inclusion/exclusion criteria. Two independent reviewers screened the title and abstract for eligibility criteria. Full texts were subsequently assessed and, finally, data were extracted. Critical Appraisal Skills Programme for qualitative and quantitative studies, and Mixed Methods Appraisal Tool for mixed-method studies were used to evaluate the quality of the studies included. <h3>Results:</h3> Within the 62 included studies, the most represented RMDs are Rheumatoid Arthritis (RA) (29.0%-18/62) and Osteoarthritis (OA) (27.4%- 17/62), and half of the studies has been conducted in Europe (31/62). Multiple tools of telemedicine were used in the studies included in the present scoping review: 33.9% (21/62) used websites and online platforms, 29.0% (18/62) used mobile applications, 25.8% (16/62) used telephone contacts, 8.1% (5/62) used video-consultations and only one study (1.6%) used wearable devices. As for the outcomes assessed, we analysed them as clinical or humanistic impact according to the Economic, Clinical, and Humanistic Outcomes (ECHO) model (see Table 1). Clinical outcomes assessed through digital tools were pain, disease activity and Serum Uric Acid (SUA) levels. While, humanistic outcomes have been grouped according to 4 categories, namely the mental and physical function, and the health management and health perception. <h3>Conclusion:</h3> the present review showed the heterogeneity of digital tools in the field of Rheumatology, highlighting the challenge of translating the findings of reliable research into clinical practice. Of all the RMDs, OA and RA have undoubtedly been studied the most. Effective tele-rehabilitation models have been presented, and the use of tight control—which has lately been shown to be essential for disease monitoring in order to achieve clinical remission—has also been mentioned. Future research should focus on establishing studies on other RMDs, such as fibromyalgia syndrome or connective tissue diseases, as well as summarizing and formulating clinical guidelines for RMDs. <b>Table 1.</b> Economic, clinical and humanistic outcomes of the studies included in the scoping review <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>