Session Title: Health Disparities/Social Determinants of Health
Session Type: Abstract Submissions (ARHP)
Background/Purpose: Telemedicine-based approaches to healthcare service delivery improve access to care. It was recognised that people with inflammatory arthritis living in rural areas had limited access to patient education and could benefit from the “Prescription for Education (RxEd)” program, an evidence-based inflammatory arthritis education program. (format: one-day, audience: adults with inflammatory conditions, facilitators: specialized arthritis care providers). The one-day program includes a variety of short presentations and panel discussions by the team, and small group, facilitator-led discussions.
The program was adapted to be delivered via interactive videoconferencing through two workshops for local and rural facilitators: Telemedicine Best Practices/Adult Education Principles; Improved Public Speaking.
The objective of this study was to evaluate the effectiveness of telemedicine delivery of “Prescription for Education” in improving arthritis self-efficacy and other secondary outcomes (arthritis knowledge, coping efficacy, illness intrusiveness, and effective consumer).
Methods: Two group, pre-post design comparing two methods of delivery, local (I, in-person) versus videoconferencing (R, remote using telemedicine), of the RxEd program.
Data were collected at baseline (T1), immediately following RxEd (T2), and at 6 months (T3). Self-report questionnaires served as the data collection tool. Measures included demographics, disorder-related, Arthritis Self-Efficacy Scale (SE), arthritis knowledge [ACREU RA knowledge questionnaire (AK)], coping efficacy (CE), Illness Intrusiveness (II), and Effective Consumer Scale (ECS). Analyses included: Univariate statistics for primary and secondary outcomes; Repeated measures analyses of variance (MANOVA) to assess change in primary outcome (SE) across T1-3 (I vs R); and Repeated measures ANOVA to assess change from pre- to immediate-post (AK) and pre- to 6-month post (CE, II, ECS) (I vs R).
Results: 123 persons completed baseline questionnaires (I n=36; R n=87), with follow-up of 81% (n=100) immediate post (T2) and 61% (n=75) at 6 months (T3). No significant baseline differences were found for: demographics, disorder-related, SE, AK, CE, II, and ECS measures.
Both groups (I and R) showed immediate effect (improved SE) after the intervention that diminished slightly over 6 months. MANOVA significant across T1-3 p<0.001 for SE. No significant differences (SE p=0.31) between groups (I vs R).
Both groups showed significant increase in knowledge (AK) from pre- to immediate post RxEd (p<0.0001), and no significant difference I vs R (ANOVA p=0.41). Both groups showed significant improvement in CE (p<0.0001), II (p=0.03), and ECS (p<0.0001) from pre- to 6-month follow-up. No significant differences (ANOVA, p-values 0.20 – 0.78) between groups (I vs R) for all secondary outcomes.
Conclusion: Improvements in arthritis self-efficacy and other secondary outcomes were equally effective in local (in-person) and remote participant groups. Access to inflammatory arthritis education in rural and remote communities is greatly increased with using Telemedicine.
Abbvie, Roche, UCB, Janssen,
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/increasing-access-to-inflammatory-arthritis-education-in-rural-and-remote-communities-using-telemedicine/