Abstract
Innovative strategies are needed to adequately assess and monitor disease activity of patients with rheumatoid arthritis (RA) in times of scarce appointments. The aim of the TELERA study is to evaluate the feasibility and performance of asynchronous telemedicine visits based on patient-generated data and patient's drug history. RA patients use a medical app, ABATON, that captures the results of a self-performed quick CRP-test, joint-count, and electronic patient-reported outcomes in between visits. This is a prospective, multi-center, randomized controlled trial performed in four German university centers. The estimated sample size is 120 patients. The main outcome is the agreement of rheumatologists' treatment decisions based on asynchronous telemedicine patient-generated data with traditional in-person rheumatology clinic-based decisions and with patient suggestions. The TELERA trial will provide evidence regarding the implementation of remote care in rheumatology.Clinical Trial Registration: This clinical trial was registered at German Registry for Clinical Trials (DRKS). http://www.drks.de/DRKS00016350, identifier: DRKS00024928.
Highlights
The treat-to-target concept has been established as a treatment principle for rheumatoid arthritis (RA) [1]
We could demonstrate that the majority of patients and rheumatologists agreed that patients in remission do not need to be seen in person [26]
The C-reactive protein (CRP) measurement was not performed by patients themselves, no joint-count was carried out and Electronic patient reported outcomes (ePROs) questionnaires were completed before tele-health follow-ups, which were synchronous
Summary
The treat-to-target concept has been established as a treatment principle for rheumatoid arthritis (RA) [1] The aim of this strategy is to define a treatment target at therapy initiation and to closely monitor treatment response in order to identify insufficient treatment success and modify the therapeutic strategy as needed. This approach represents a challenge for rheumatologists as frequent, one to three-monthly assessments are recommended in patients with active disease and resources are limited [1,2,3]. This situation is likely to worsen as the current shortage of rheumatologists in Germany and other nations will probably increase even further in the future [5, 6]
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