SP0133 Patient experiences from a tele-health intervention on disease activity in ra: the keen and the reluctant patient

Abstract

Background 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.1 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.2-3 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. Objectives 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. Methods Adopting a strategy of interpretive description,4 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. Results 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. Conclusions 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. References [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. Interpretive description: Qualitative Research for Applied Practice. New York and London: Routledge; 2016 (2nd ed.). Disclosure of Interest None declared