Table 1.

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

Study	Study design	Disease	N°	Demographics*	Intervention	Control	Outcomes	Results†	RoB‡
Berdal et al 11	RCT	RA, SpA, PsA, SLE, OA	389	Age: 58 y Female: 71% FU duration: 12 mo	Self-management booklet, goal setting interviews, telephone FU, additionally to traditional rehabilitation programme	Traditional rehabilitation programme	Efficacy (HRQoL/PGI)	Better HRQoL values at discharge; no differences in other outcomes at any timepoints	RoB 2: low
Gossec et al 24	RCT	RA	320	Age: 57 y Female: 79% FU duration: 12 mo	E-health platform for health self-assessment and storing questions, additionally to rheumatology visits	Rheumatology visits	User perception	Better patient-physician interactions and patient perceived care	RoB 2: some concern
Khan et al 13	RCT	SLE	50	Age: 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 physician	Efficacy (FACIT-F; BPI-SF; QoL)	Less fatigue, pain and QoL outcomes	RoB 2: high
Pers et al 14	RCT	RA in moderate/high disease activity	94	Age: 18–75 y§ Female: 75% FU duration: 6 mo	Smartphone app notifying rheumatologist for the necessity of a visit	Standard care	Efficacy (N° of visits, DAS28; HAQ; RAPID-3; SF-12) Safety (adverse events) User perception	Lower n° of total visits, no differences in other outcomes	RoB 2: high
Salaffi et al 16	RCT	Early RA	41	Age: 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 strategy	Efficacy (RAID; CDAI) 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 made	RoB 2: high
Song et al 15	RCT	RA	92	Age: 55 y Female: 71% FU duration: 24 w	Telephone education (medication, side effects, exercise, psychological approaches), additionally to standard care	Standard care	Efficacy (DAS28) Adherence	Better for compliance and medication adherence, no difference in disease activity	RoB 2: high
Taylor-Gjevre et al 17	RCT	Inflammatory arthritis	85	Age: 56 y Female: 20% FU duration: 9 mo	Remote diagnostic videoconference including physical exam by an on-site physical therapist	In person (F2F) rheumatology FU	Efficacy (DAS28; EQ-5D; RADAI) User perception	No differences	RoB 2: high
de Thurah et al 12	RCT	RA in low disease activity	294	Age: 61 y Female 69% FU duration: 52 w	Telehealth FU every 3–4 mo	Outpatient department every 3–4 mo	Efficacy (DAS28; HAQ; EQ-5D) Adherence	Non-inferiority between intervention and control	RoB 2: low
Ammerlaan et al 23	Cohort study	Patients with RMDs	19	Age: 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 content	User perception	No differences	ROBINS-I: serious
Kennedy et al 18	Cohort study	Patients with RMDs (RA, PsA, SLE, IBD, arthritis, gout)	123	Age: 58 y Female: 90% FU duration: 6 mo	Teleconference for patient education (learning best practices, integration of self-management strategies)	F2F meeting with identical programme	Efficacy (self-efficacy)	No differences	ROBINS-I: serious
Leggett et al 19	Cohort study	New rheumatology referrals	100	Age: 48 y Female: 75% FU duration: two visits (no info)	Diagnostic telephone and subsequent teleconference consultation between patients and rheumatologists in a general practitioner office	F2F meeting	Efficacy (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 F2F	ROBINS-I: moderate
Nguyen-Oghalai et al 20	Cohort study	Veterans with suspected RMDs	38	Age: 57 y Female: 8% FU duration: 2–3 mo	Diagnostic videoconference between patient, nurse practitioner (same place) and rheumatologist	F2F visit with the same patients, 2–3 mo after videoconference	Efficacy (diagnostic accuracy) User perception	No statistical comparisions performed	ROBINS-I: moderate
Wood et al 22	Cohort study	Veterans with inflammatory arthritis	85	Age: 64 y Female: 15% FU duration: not given	Telemedicine care (videoconference)	Usual care (F2F)	Efficacy (travel distance) User perception Cost-effectiveness	Costs and distance of driving decreased when switching from usual to telemedicine care. No difference in satisfaction with medical care	ROBINS-I: serious
Kessler et al 21	Cross-sectional study	Paediatric patients with RMDs	338	No information reported	Telemedicine clinic for routine FU visits	In person visits in a rheumatology clinic	Efficacy (time schedule) Cost-effectiveness	Less distance travelled, less hours missed for work/school, less expenses for food/lodging, higher interest in telehealth	NA

*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.