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Rheumatology Care Using Telemedicine.

Michael M Rezaian1,2, Lawrence H Brent3, Shima Roshani4

  • 1Rural Outreach Arthritis Center, Martinsburg, West Virginia.

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|May 16, 2019
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Summary

This study demonstrates successful telemedicine for rheumatologic care in underserved regions, evaluating over 4,800 patients remotely. The program effectively managed rheumatic diseases, including arthritis, using various medications and treatments.

Keywords:
rheumatologyrural health servicestelehealthtelemedicine

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Area of Science:

  • Rheumatology
  • Telemedicine
  • Global Health

Background:

  • Limited access to specialized rheumatologic, musculoskeletal, and connective tissue disease diagnostics and therapies exists globally, particularly in rural areas of low- and middle-income countries.
  • Addressing this disparity is crucial for improving patient outcomes and quality of life in underserved populations.

Purpose of the Study:

  • To report on the successful implementation and outcomes of a telemedicine program for evaluating and treating patients with rheumatologic and musculoskeletal diseases in Iran.
  • To assess the feasibility and effectiveness of remote rheumatologic consultations in a region with limited access to specialized care.

Main Methods:

  • A 5-year telemedicine program involved a US-based rheumatologist remotely evaluating over 4,800 patients in northeastern Iran, supported by local healthcare professionals.
  • Patients were seen online three days a week, with a subset receiving in-person evaluations every four months.
  • Data collected included demographics, diagnoses, diagnostic tests utilized, and prescribed medications, analyzed using descriptive statistics.

Main Results:

  • The average patient age was 52, with 89% being women; 50% were Afghan refugees.
  • Common diagnoses included osteoarthritis (23.6%), rheumatoid arthritis (13.4%), axial spondyloarthropathies (13.3%), and lumbar spinal stenosis (8.8%).
  • Prescribed medications ranged from non-steroidal anti-inflammatory drugs (16.3%) and methotrexate (15.7%) to biologic agents like etanercept (2.0%) and tofacitinib (1.3%).

Conclusions:

  • Telemedicine is a viable and effective solution for delivering specialized rheumatologic care to remote and underserved populations.
  • The program successfully evaluated and managed a diverse range of rheumatic diseases, demonstrating the potential of remote healthcare delivery models.
  • This initiative highlights the importance of international collaboration in bridging healthcare access gaps for patients with chronic conditions.