Abstract
BackgroundThe worldwide burden of musculoskeletal diseases is increasing. The number of newly registered rheumatologists has stagnated. Primary care, which takes up a key role in early detection of rheumatic disease, is working at full capacity. COVID-19 and its containment impede rheumatological treatment. Telemedicine in rheumatology (telerheumatology) could support rheumatologists and general practitioners.ObjectiveThe goal of this study was to investigate acceptance and preferences related to the use of telerheumatology care among German rheumatologists and general practitioners.MethodsA nationwide, cross-sectional, self-completed, paper-based survey on telerheumatology care was conducted among outpatient rheumatologists and general practitioners during the pre-COVID-19 period.ResultsA total of 73.3% (349/476) of survey participants rated their knowledge of telemedicine as unsatisfactory, poor, or very poor. The majority of survey participants (358/480, 74.6%) answered that they do not currently use telemedicine, although 62.3% (291/467) would like to. Barriers to the implementation of telemedicine include the purchase of technology equipment (182/292, 62.3%), administration (181/292, 62.0%), and poor reimbursement (156/292, 53.4%). A total of 69.6% (117/168) of the surveyed physicians reckoned that telemedicine could be used in rheumatology. Surveyed physicians would prefer to use telemedicine to communicate directly with other physicians (370/455, 81.3%) than to communicate with patients (213/455, 46.8%). Among treatment phases, 64.4% (291/452) of participants would choose to use telemedicine during follow-up. Half of the participants would choose telecounseling as a specific approach to improve rheumatology care (91/170, 53.5%).ConclusionsBefore COVID-19 appeared, our results indicated generally low use but high acceptance of the implementation of telerheumatology among physicians. Participants indicated that the lack of a structural framework was a barrier to the effective implementation of telerheumatology. Training courses should be introduced to address the limited knowledge on the part of physicians in the use of telemedicine. More research into telerheumatology is required. This includes large-scale randomized controlled trials, economic analyses, and the exploration of user preferences.
Highlights
The worldwide burden of musculoskeletal diseases is increasing [1]
Half of the participants would choose telecounseling as a specific approach to improve rheumatology care (91/170, 53.5%)
This paper reports on findings from the analysis of data collected as part of a cross-sectional, self-completed, paper-based survey of German outpatient rheumatologists and general practitioners from September to November 2018; the survey investigated acceptance, opportunities, and obstacles to the implementation of telemedicine
Summary
The worldwide burden of musculoskeletal diseases is increasing [1]. Growing life expectancy, widespread overweight, and a frequent lack of exercise have caused a surge in musculoskeletal disorders. While increasingly effective treatments have been developed and implemented, the number of newly registered rheumatologists has stagnated [3], and the global need for rheumatologists cannot be met [4]. General practitioners are usually the first point of contact for patients and play an important role in the early detection of rheumatic and musculoskeletal diseases (RMDs). Primary care is affected by a shortage of staff and, in view of demographic change, an increasingly demanding work burden [5,6]. The number of newly registered rheumatologists has stagnated. Primary care, which takes up a key role in early detection of rheumatic disease, is working at full capacity. Telemedicine in rheumatology (telerheumatology) could support rheumatologists and general practitioners
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