Remote Patient Monitoring Shows Promise for Reducing Use of Healthcare Resources

Use of electronic Patient Reported Outcome Measures (ePROMs) among patients with inflammatory arthritides (IA) may yield comparable outcomes to in-person monitoring, offering a reduced burden of healthcare resource utilization, according to study results published in the Arthritis & Rheumatology.

A significant amount of follow-up visits in rheumatology clinics are due to IA. In an effort to offset the increasing clinician workload, researchers evaluated the utility of ePROMs as a healthcare resource for monitoring disease activity and treatment decisions.

A systematic literature review was conducted to identify nonrandomized and randomized controlled trials (RCTs) that evaluated the clinical impact of ePROM utilization among patients with IA.

Meta-analyses were conducted to assess outcomes of interest, including rates of remission, treatment intensification, disease flare, face-to-face appointments, and between-group disease activity scores.

Data from 8 studies comprised of 4473 patients were included in the review, of which 6 were RCTs and 2 were pre-post observational cohort studies. Seven of the 8 studies focused on patients with rheumatoid arthritis.

A meta-analysis of studies using ePROM measures revealed that disease activity was lower at follow-up among the ePROM groups compared with control groups (standardized mean difference [SMD], -0.15; 95% CI, -0.27 to -0.03). A sensitivity analysis adjusted for follow-up length revealed similar findings (SMD, -0.21; 95% CI, -0.37 to -0.05). Despite a small effect size, none of the studies utilizing ePROM monitoring demonstrated worsening patient disease activity.

A total of 5 studies evaluated remission and/or low disease activity between ePROM and control groups. Higher rates of remission were found among the ePROM groups at follow-up (odds ratio, 1.65; 95% CI, 1.02-2.68).

When evaluating for resource utilization, fewer face-to-face visits were necessary during follow-up among ePROM vs control groups (SMD, -0.93; 95% CI, -2.14 to 0.28).

This analysis was limited by risk for bias and heterogeneity among the included studies.

The study authors concluded, “The findings are encouraging in the current climate and show promise in the potential of ePROM remote monitoring as an adjunct to care, with potential for reduction in other healthcare resource use. Further robust and focused research in the use of ePROM monitoring as a lone adjunct compared to routine care is needed, with longer follow-up.”

Disclosure: One or more of the study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

This article originally appeared on Rheumatology Advisor