A prospective comparison of telemedicine versus in-person delivery of an interprofessional education program for adults with inflammatory arthritis

Author:

Kennedy Carol A123,Warmington Kelly45,Flewelling Carol6,Shupak Rachel7,Papachristos Angelo7,Jones Caroline7,Linton Denise1,Beaton Dorcas E128910,Lineker Sydney11,Hogg-Johnson Sheilah212

Affiliation:

1. Musculoskeletal Health and Outcomes Research, St. Michael’s Hospital, Canada

2. Institute for Work and Health, Canada

3. Department of Physical Therapy, University of Toronto, Canada

4. Knowledge Translation, The Hospital for Sick Children, Canada

5. Learning Institute, The Hospital for Sick Children, Canada

6. Telemedicine Program, St. Michael’s Hospital, Canada

7. Martin Family Centre for Arthritis Care & Research, St. Michael’s Hospital, Canada

8. Graduate Department of Health Policy, Management and Evaluation, University of Toronto, Canada

9. Graduate Department of Rehabilitation Science, University of Toronto, Canada

10. Department of Occupational Science and Occupational Therapy, University of Toronto, Canada

11. The Arthritis Society (Ontario Division), Canada

12. Dalla Lana School of Public Health, University of Toronto, Canada

Abstract

Introduction We evaluated two modes of delivery of an inflammatory arthritis education program (“Prescription for Education” (RxEd)) in improving arthritis self-efficacy and other secondary outcomes. Methods We used a non-randomized, pre-post design to compare videoconferencing (R, remote using telemedicine) versus local (I, in-person) delivery of the program. Data were collected at baseline (T1), immediately following RxEd (T2), and at six months (T3). Self-report questionnaires served as the data collection tool. Measures included demographics, disorder-related, Arthritis Self-Efficacy Scale (SE), previous knowledge (Arthritis Community Research and Evaluation Unit (ACREU) rheumatoid arthritis knowledge questionnaire), coping efficacy, Illness Intrusiveness, and Effective Consumer Scale. Analysis included: baseline comparisons and longitudinal trends (R vs I groups); direct between-group comparisons; and Generalized Estimating Equations (GEE) analysis. Results A total of 123 persons attended the program (I: n = 36; R: n = 87) and 111 completed the baseline questionnaire (T1), with follow-up completed by 95% ( n = 117) at T2 and 62% ( n = 76) at T3. No significant baseline differences were found across patient characteristics and outcome measures. Both groups (R and I) showed immediate effect (improved arthritis SE, mean change (95% confidence interval (CI)): R 1.07 (0.67, 1.48); I 1.48 (0.74, 2.23)) after the program that diminished over six months (mean change (95% CI): R 0.45 (−0.1, 0.1); I 0.73 (−0.25, 1.7)). For each of the secondary outcomes, both groups showed similar trends for improvement (mean change scores (95% CI)) over time. GEE analysis did not show any meaningful differences between groups (R vs I) over time. Discussion Improvements in arthritis self-efficacy and secondary outcomes displayed similar trends for I and R participant groups.

Publisher

SAGE Publications

Subject

Health Informatics

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