title: A prospective comparison of telemedicine versus in-person delivery of an interprofessional education program for adults with inflammatory arthritis.
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 T2and 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.
authors.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.
authors.forename: Carol A
authors.initials: CA
authors.lastname: Kennedy
authors.affiliation: 4 Knowledge Translation, The Hospital for Sick Children, Canada.|5 Learning Institute, The Hospital for Sick Children, Canada.
authors.forename: Kelly
authors.initials: K
authors.lastname: Warmington
authors.affiliation: 6 Telemedicine Program, St. Michael's Hospital, Canada.
authors.forename: Carol
authors.initials: C
authors.lastname: Flewelling
authors.affiliation: 7 Martin Family Centre for Arthritis Care & Research, St. Michael's Hospital, Canada.
authors.forename: Rachel
authors.initials: R
authors.lastname: Shupak
authors.affiliation: 7 Martin Family Centre for Arthritis Care & Research, St. Michael's Hospital, Canada.
authors.forename: Angelo
authors.initials: A
authors.lastname: Papachristos
authors.affiliation: 7 Martin Family Centre for Arthritis Care & Research, St. Michael's Hospital, Canada.
authors.forename: Caroline
authors.initials: C
authors.lastname: Jones
authors.affiliation: 1 Musculoskeletal Health and Outcomes Research, St. Michael's Hospital, Canada.
authors.forename: Denise
authors.initials: D
authors.lastname: Linton
authors.affiliation: 1 Musculoskeletal Health and Outcomes Research, St. Michael's Hospital, Canada.|2 Institute for Work and Health, 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.
authors.forename: Dorcas E
authors.initials: DE
authors.lastname: Beaton
authors.affiliation: 11 The Arthritis Society (Ontario Division), Canada.
authors.forename: Sydney
authors.initials: S
authors.lastname: Lineker
authors.affiliation: 2 Institute for Work and Health, Canada.|12 Dalla Lana School of Public Health, University of Toronto, Canada.
authors.forename: Sheilah
authors.initials: S
authors.lastname: Hogg-Johnson
mesh_terms: D000223:Adaptation, Psychological; D001168:Arthritis / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D011446:Prospective Studies; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D017216:Telemedicine / Q000379:methods*; D049269:Videoconferencing
keywords: Tele-education; arthritis; telehealth; telemedicine