A prospective comparison of telemedicine versus in-person delivery of an interprofessional education program for adults with inflammatory arthritis

Publication type
Journal article
Kennedy CA Warmington K Flewelling C Shupak R Papachristos A Jones C Linton D Beaton DE Lineker S Hogg-Johnson S
Date published
2017 Jan 25
Journal of Telemedicine and Telecare
Open Access?

INTRODUCTION: We evaluated two modes of delivery of an inflammatory arthritis education program ('Prescription for Education' (RxEd)) in improving arthritis self-efficacy and other secondary outcomes. METHODS: We used a non-randomized, pre-post design to compare videoconferencing (R, remote using telemedicine) versus local (I, in-person) delivery of the program. Data were collected at baseline (T1), immediately following RxEd (T2), and at six months (T3). Self-report questionnaires served as the data collection tool. Measures included demographics, disorder-related, Arthritis Self-Efficacy Scale (SE), previous knowledge (Arthritis Community Research and Evaluation Unit (ACREU) rheumatoid arthritis knowledge questionnaire), coping efficacy, Illness Intrusiveness, and Effective Consumer Scale. Analysis included: baseline comparisons and longitudinal trends (R vs I groups); direct between-group comparisons; and Generalized Estimating Equations (GEE) analysis. RESULTS: A total of 123 persons attended the program (I: n = 36; R: n = 87) and 111 completed the baseline questionnaire (T1), with follow-up completed by 95% (n = 117) at T2 and 62% (n = 76) at T3. No significant baseline differences were found across patient characteristics and outcome measures. Both groups (R and I) showed immediate effect (improved arthritis SE, mean change (95% confidence interval (CI)): R 1.07 (0.67, 1.48); I 1.48 (0.74, 2.23)) after the program that diminished over six months (mean change (95% CI): R 0.45 (-0.1, 0.1); I 0.73 (-0.25, 1.7)). For each of the secondary outcomes, both groups showed similar trends for improvement (mean change scores (95% CI)) over time. GEE analysis did not show any meaningful differences between groups (R vs I) over time. DISCUSSION: Improvements in arthritis self-efficacy and secondary outcomes displayed similar trends for I and R participant groups