RA disease activity, provider preference linked to telehealth appropriateness

Telehealth appropriateness is significantly associated with provider preference, the current and previous encounter modality, and rheumatoid arthritis (RA) disease activity, but not with RA medications, patient demographics, and comorbid noninflammatory causes of joint pain, a study has shown. 

Researchers conducted this prospective cohort study from 1 January 2021 to 31 August 2021 using electronic health record data from outpatient RA encounters in a single academic rheumatology practice. Using the Encounter Appropriateness Score for You (EASY), rheumatology providers rated the telehealth appropriateness of their own experience immediately following each encounter. 

The research team assessed the relationship of telehealth appropriateness with patient demographics, RA clinical characteristics, comorbid noninflammatory causes of joint pain, previous and current encounter characteristics, and provider characteristics using robust Poisson regression with generalized estimating equations modelling. 

Overall, 1,823 outpatient encounters with 1,177 unique RA patients received an EASY score from 25 rheumatology providers. 

The final multivariate model revealed the following factors associated with increased telehealth appropriateness: higher average provider preference for telehealth in prior encounters (relative risk [RR], 1.26, 95 percent confidence interval [CI], 1.21–1.31), telehealth as the current encounter modality (RR, 2.27, 95 percent CI, 1.95–2.64), and increased patient age (RR, 1.05, 95 percent CI, 1.01–1.09). 

On the other hand, the following factors correlated with decreased telehealth appropriateness: moderate (RR, 0.81, 95 percent CI, 0.68–0.96) and high (RR, 0.57, 95 percent CI, 0.46–0.70) RA disease activity and if the previous encounters were conducted by telehealth (RR, 0.83, 95 percent CI, 0.73–0.95).