Table 1

Studies on the value of remote care in inflammatory RMDs (PICO 1)

StudyStudy designDiseaseDemographics*InterventionControlOutcomesResults†RoB‡
Berdal et al 11RCTRA, SpA, PsA, SLE, OA389Age: 58 y
Female: 71%
FU duration: 12 mo
Self-management booklet,
goal setting interviews,
telephone FU,
additionally to traditional rehabilitation programme
Traditional rehabilitation programmeEfficacy
Better HRQoL values at discharge; no differences in other outcomes at any timepointsRoB 2: low
Gossec et al24RCTRA320Age: 57 y
Female: 79%
FU duration: 12 mo
E-health platform for health self-assessment and storing questions,
additionally to rheumatology visits
Rheumatology visitsUser perceptionBetter patient-physician interactions and patient perceived careRoB 2: some concern
Khan et al13RCTSLE50Age: 43 y
Female: 95%
FU duration: 16 w
Smartphone/Web application for tracking lifestyle activities and disease triggers,
telephone calls to discuss lifestyle modifications,
additionally to usual care
Usual care as recommended by treating physicianEfficacy
Less fatigue, pain and QoL outcomesRoB 2: high
Pers et al14RCTRA in moderate/high disease activity94Age: 18–75 y§
Female: 75%
FU duration: 6 mo
Smartphone app notifying rheumatologist for the necessity of a visitStandard careEfficacy
(N° of visits, DAS28; HAQ; RAPID-3; SF-12)
(adverse events)
User perception
Lower n° of total visits, no differences in other outcomesRoB 2: high
Salaffi et al16RCTEarly RA41Age: 50 y
Female: 75%
FU duration: 12 mo
Web application for disease activity assessment and user perception,
telephone calls in case of active disease
Conventional strategyEfficacy
User perception
Better according to the number of patients reaching remission and time to remission. Better for function radiological progression. Patient satisfaction was high with the application, but no comparisions were madeRoB 2: high
Song et al15RCTRA92Age: 55 y
Female: 71%
FU duration: 24 w
Telephone education (medication, side effects, exercise, psychological approaches),
additionally to standard care
Standard careEfficacy
Better for compliance and medication adherence, no difference in disease activityRoB 2: high
Taylor-Gjevre et al17RCTInflammatory arthritis85Age: 56 y
Female: 20%
FU duration: 9 mo
Remote diagnostic videoconference including physical exam by an on-site physical therapistIn person (F2F) rheumatology FUEfficacy
User perception
No differencesRoB 2: high
de Thurah et al12RCTRA in low disease activity294Age: 61 y
Female 69%
FU duration: 52 w
Telehealth FU every 3–4 moOutpatient department every 3–4 moEfficacy
(DAS28; HAQ; EQ-5D)
Non-inferiority between intervention and controlRoB 2: low
Ammerlaan et al23Cohort studyPatients with RMDs19Age: 22 y
Female: 84%
FU duration: 6 w
Six-week long interactive online programme (chatting with peers and peer leaders, home exercises, discussion board)Three-day F2F programme with similar contentUser perceptionNo differencesROBINS-I: serious
Kennedy et al18Cohort studyPatients with RMDs (RA, PsA, SLE, IBD, arthritis, gout)123Age: 58 y
Female: 90%
FU duration: 6 mo
Teleconference for patient education (learning best practices, integration of self-management strategies)F2F meeting with identical programmeEfficacy
No differencesROBINS-I: serious
Leggett et al19Cohort studyNew rheumatology referrals100Age: 48 y
Female: 75%
FU duration: two visits (no info)
Diagnostic telephone and subsequent teleconference consultation between patients and rheumatologists in a general practitioner officeF2F meetingEfficacy
(diagnostic accuracy)
User perception
Numerically better diagnostic accuracy, patient and general practitioner satisfaction in the teleconference group compared with telephone consultations alone, no difference between teleconference and F2FROBINS-I: moderate
Nguyen-Oghalai et al20Cohort studyVeterans with suspected RMDs38Age: 57 y
Female: 8%
FU duration: 2–3 mo
Diagnostic videoconference between patient, nurse practitioner (same place) and rheumatologistF2F visit with the same patients, 2–3 mo after videoconferenceEfficacy
(diagnostic accuracy)
User perception
No statistical comparisions performedROBINS-I: moderate
Wood et al22Cohort studyVeterans with inflammatory arthritis85Age: 64 y
Female: 15%
FU duration: not given
Telemedicine care (videoconference)Usual care (F2F)Efficacy
(travel distance)
User perception
Costs and distance of driving decreased when switching from usual to telemedicine care. No difference in satisfaction with medical careROBINS-I: serious
Kessler et al21Cross-sectional studyPaediatric patients with RMDs338No information reportedTelemedicine clinic for routine FU visitsIn person visits in a rheumatology clinicEfficacy
(time schedule)
Less distance travelled, less hours missed for work/school, less expenses for food/lodging, higher interest in telehealthNA
  • *Age/Female ratio was calculated by the sum of age (mean or median) or female ratio (%) of intervention and control groups, respectively and divided by the number of groups, unless reported otherwise.

  • †Results are reported in respect to the comparison of the intervention with the control.

  • ‡Overall RoB is reported according to the RoB 2 tool (low, some concern, high RoB) and the ROBINS-I tool (low, moderate, serious RoB). Cross-sectional and qualitative studies were assessed using the Joanna Briggs Institute Critical Appraisal checklists which do not determine an overall RoB (therefore reported as ‘NA’).

  • §Age was reported as the number of patients (%) in age categories: 18–39 years: 8 (9); 40–59 years 41 (46); 60–75 years: 40 (45).

  • BPI-SF, Brief Pain Inventory Short Form; CDAI, Clinical Disease Activity Index; DAS28, Disease Activity Score based on 28 joints; EQ-5D, European Quality of Life 5 Dimensions; FACIT-F, Functional Assessment of Chronic Illness Therapy-Fatigue; F2F, face-to-face; FU, follow-up; HAQ, Health Assessment Questionnaire; HRQoL, Health-Related Quality of Life; IBD, inflammatory bowel disease; mo, months; NA, not available; PGI, patient generated index; PsA, psoriatic arthritis; QoL, quality of life; RA, rheumatoid arthritis; RADAI, Rheumatoid Arthritis Disease Activity Index; RAID, Rheumatoid Arthritis Impact of Disease; RAPID-3, Routine Assessment of Patient Index Data 3; RCT, randomised controlled trial; RMDs, rheumatic musculoskeletal disease; RoB, risk of bias; ROBINS-I, risk-of-bias tool for non-randomised studies of interventions; SF-12, Short Form 12; SLE, systematic lupus erythematosus; SpA, spondyloarthritis; w, weeks; y, years.