The following is a summary of “Patient-initiated follow-up supported by asynchronous telemedicine versus usual care in spondyloarthritis (TeleSpA-study): a randomised controlled trial of clinical and cost-effectiveness,” published in the December 2024 issue of Rheumatology by Hermans et al. 

Rising health-care costs and workforce shortages demand efficient alternatives to traditional outpatient follow-up to optimize care. 

Researchers conducted a retrospective study to evaluate the cost-effectiveness and clinical effectiveness of patient-initiated follow-up (PIFU) with asynchronous telemedicine for patients with spondyloarthritis. 

They conducted a multicenter, open-label, randomized controlled trial, assigning 200 patients with stable spondyloarthritis (1:1) to either the PIFU and asynchronous telemedicine group (n=100) or the usual care group (n=100). All patients had baseline and 1-year outpatient visits, with remote monitoring at 6 months for the PIFU group. The primary outcome was the number of rheumatology visits within 1 year. A 1-year health-economic evaluation was performed from both a Dutch healthcare and societal perspective. Safety was assessed through adverse events (AEs) reports in the intention-to-treat population. The relevant lived experience informed the study design. 

The results showed that 200 patients were assigned to PIFU and asynchronous telemedicine (n=100) or usual care (n=100). Of the participants, 79 (40%) were women, 121 (60%) were men, and the mean age was 55.0 years (SD 11.9). After 1 year, the PIFU group had 1.9 (SD 1.5) rheumatology visits, and the usual care group had 2.6 (SD 1.3) visits (mean difference –0.7, 25.4% reduction, P<0.0001). PIFU was cost-effective, saving €180 (95% CI –921 to 560) without a loss in quality-adjusted life-years (0.004, 95% CI –0.022 to 0.030). The PIFU group had 7 non-trial-related AEs, and the usual care group had 8 (including 1 death). 

Investigators found that PIFU and asynchronous telemedicine significantly reduced rheumatology visits without compromising health outcomes. This approach proved cost-effective, saving healthcare costs. 

Source: thelancet.com/journals/lanrhe/article/PIIS2665-9913(24)00229-7/abstract