Telerheumatology to improve first access outcomes in outpatients: a prospective monocentric pilot study

Objective. The present pilot study aimed to assess the feasibility of a 'teletriagerheum' service before the first rheumatology visit and identify potential benefits and disadvantages by comparing a regular visit with a first face-to-face visit preceded by the ‘teletriagerheum' service.

Methods. A prospective monocentric pilot study was conducted from October to December 2021. Consecutive patients were contacted to investigate their willingness to receive a phone call ('teletriagerheum' service) from a physician of the Rheumatology Unit before the first rheumatology visit. The number of definite diagnoses at the first visit in the 'teletriagerheum' group was compared with patients receiving a regular first visit, as well as socio-demographic characteristics, the reason for the visit, face-to-face visit duration, and the number of additional exams.

Results. Overall, 75 patients performed the 'teletriagerheum' ('teletriagerheum' group), and 74 patients were included in the control group. In the 'teletriagerheum' group, a higher number of conclusive diagnoses was observed (72% vs. 58%, p=0.020) with a higher probability of receiving a conclusive diagnosis compared with the control group, both at univariate [odds ratio (OR) 2.28, p=0.021] and multivariate analyses adjusting for the only differences between the two groups (marital status and information and communication technologies skills; OR 2.95, p=0.007). At the first face-to-face visit, fewer additional tests were prescribed in the 'teletriagerheum' group; however, the overall number of tests (including those prescribed during teletriage) was higher.

Conclusions. A telephone-based telerheumatology service could be an effective triage tool for first visits of new outpatients, enabling more definitive diagnoses, thanks in part to the ability to perform the required investigations in a timely manner in most cases.