Journal of Telemedicine and Telecare最新文献

{"title":"Association between telehealth use in oncology and downstream utilization at a large academic health system.","authors":"Preeti Kakani, Adam E Singer, Manying Cui, Chad W Villaflores, Sitaram Vangala, Miguel A Cuevas, Maria Han, Cheryl L Damberg, John N Mafi, Catherine A Sarkisian","doi":"10.1177/1357633X241282820","DOIUrl":"10.1177/1357633X241282820","url":null,"abstract":"<p><p>BackgroundWhile telemedicine has been beneficial in oncology by reducing infectious exposure and improving access for patients with poor functional status, it also has intrinsic limitations, including the inability to perform a physical exam, which could lead to increased downstream utilization in this population at high risk of medical decompensation. We conducted a retrospective cohort study investigating the relationship between telemedicine use in oncology and subsequent outpatient oncology encounters, emergency department (ED) visits, and hospitalizations.MethodsWe included outpatient oncology encounters, including telemedicine and in-person visits, occurring between 1 January 2018 and 31 December 2022 at a large academic health system. Unadjusted descriptive statistics and multiple linear regressions were used to estimate subsequent outpatient oncology visits, ED visits, and hospitalizations within 30 days of an index visit based on modality (telemedicine versus in-person). The multiple regressions were adjusted for various demographic and clinical characteristics, including palliative care visits, baseline utilization, recent chemotherapy, and comorbidities.ResultsOur cohort included 63,722 patients with 689,356 outpatient encounters, of which 639,217 (92.7%) were in-person and 50,139 (7.3%) were telemedicine visits. Patients on average had 0.91 outpatient oncology visits, 0.04 ED visits, and 0.05 hospitalizations within 30 days following an index encounter. In our adjusted analyses, telemedicine was associated with 13.7 fewer downstream outpatient oncology visits (95% CI 12.5-14.9; <i>p</i> < 0.001) per 100 index encounters, 0.7 fewer ED visits (95% CI 0.4-1.0; <i>p</i> < 0.001) per 100 index encounters and 0.9 fewer hospitalizations (95% CI 0.6-1.3; <i>p</i> < 0.001) per 100 index encounters compared to in-person visits.ConclusionsContrary to our hypothesis, oncology patients who had a telemedicine visit had fewer follow-up outpatient oncology encounters, ED visits and hospitalizations after 30 days than those with in-person visits. Future studies should further investigate the efficacy of telemedicine in oncology and outline specific scenarios for appropriate use in this and other populations.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"1326-1335"},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12009617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of telemedicine for trauma care since the Russian invasion of Ukraine: A qualitative assessment.","authors":"Tracey Pérez Koehlmoos, Amandari Kanagaratnam, Jessica Korona-Bailey, Zoe Amowitz, John S Maddox, Tiffany E Hamm, Oleh Berezyuk, Lynn Lieberman Lawry","doi":"10.1177/1357633X241288299","DOIUrl":"10.1177/1357633X241288299","url":null,"abstract":"<p><p>IntroductionUkraine's health and trauma system has been detrimentally impacted since the start of the Russian invasion in February 2022. Use of telemedicine became critical to providing timely medical care. As such, the aim of this study was to describe telemedicine's use in the health and trauma system of Ukraine following the full-scale invasion.MethodsWe conducted qualitative key informant interviews with military and civilian health care workers using an expanded version of the Global Trauma System Evaluation Tool which had components focusing on telemedicine use. Thematic content analysis was used to derive key telemedicine themes from interviews.ResultsWe conducted 36 key informant interviews. Most respondents described using telemedicine through informal means of communication such as messaging apps to meet patient care needs. Concerns and challenges with use of telemedicine included weapons targeting, internet connections and safety of communications from Russian hackers. A unified system for telemedicine would greatly improve use in country both during and post conflict.DiscussionTelemedicine use has rapidly increased in Ukraine during the current conflict particularly in the scope of providing trauma care when numerous specialties are needed. Development of a unified, secure telemedicine system with mechanisms for integrating multinational medical support would aid in providing swift medical care to persons injured in the conflict or unable to access a specialty provider in their proximity.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"1344-1350"},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of telehealth-directed emergency front-of-neck access (FONA).","authors":"Benjamin Powell, Alastair Newton, Clinton Gibbs","doi":"10.1177/1357633X241272946","DOIUrl":"10.1177/1357633X241272946","url":null,"abstract":"<p><p>In this case, we describe the completion of emergency front-of-neck access by a novice provider facilitated by specialist telehealth support. A facility with limited advanced airway skills requested telehealth support for a critically unwell patient with severe hypoxic respiratory failure and acute delirium. Attempts to temporise his physiology with ketamine-facilitated non-invasive ventilation were unsuccessful, and he proceeded to rapid sequence intubation. Ultimately, intubation was unsuccessful and attempts at ventilation by laryngeal mask also failed. A Cannot Intubate, Cannot Oxygenate scenario was identified. The referring team had significant anxiety about performing a surgical front-of-neck access procedure. However, with telehealth support, this was ultimately completed by a novice provider, and the patient stabilised. The key issue identified was the need for the telehealth provider to take clinical governance of the procedure. The referring team also required assistance in completing an adequate neck incision, responding to bleeding, and determining the preferred technique.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"1351-1353"},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A randomised trial of real-time video counselling for smoking cessation among rural and remote residents.","authors":"Flora Tzelepis, John Wiggers, Christine L Paul, Aimee Mitchell, Emma Byrnes, Judith Byaruhanga, Louise Wilson, Christophe Lecathelinais, Jennifer Bowman, Elizabeth Campbell, Karen Gillham","doi":"10.1177/1357633X241273076","DOIUrl":"10.1177/1357633X241273076","url":null,"abstract":"<p><p>IntroductionDespite its reach, very limited evidence exists on the effectiveness of real-time video counselling for smoking cessation (e.g. via Skype). This study compared the effectiveness of real-time video counselling for smoking cessation to (a) telephone counselling; and (b) a control among rural and remote residents.MethodsBetween 25 May 2017 and 3 March 2020, a three-arm, parallel group, randomised trial, randomised 1244 rural and remote residents from New South Wales, Australia who smoked tobacco to: video counselling (4-6 video sessions); telephone counselling (4-6 telephone calls); or a control (printed materials). The primary outcome was 7-day point prevalence abstinence at 13 months post-baseline. Secondary outcomes were point prevalence abstinence at 4 months and 7-months post-baseline, prolonged abstinence, quit attempts, anxiety and depression.ResultsFor the primary outcome of 7-day point prevalence abstinence at 13 months post-baseline, there was no significant difference between video counselling and telephone counselling (14.6% vs 13.3%; (OR = 1.11, 95% CI (0.75-1.64), <i>P</i> = 0.61) or video counselling and control (14.6% vs 13.9%; (OR = 1.06, 95% CI (0.71-1.57), <i>P</i> = 0.77). For secondary outcomes at 4 months post-baseline, the video counselling group had significantly higher odds than the control of 7-day point prevalence abstinence (14.3% vs 8.2%; OR = 1.88, 95% CI (1.20-2.95), <i>P</i> = 0.006) and 3-month prolonged abstinence (4.9% vs 2.2%; OR = 2.28, 95% CI (1.03-5.07), <i>P</i> = 0.04). There were no significant differences for other secondary outcomes.DiscussionVideo counselling increased smoking cessation in the short-term compared to a control although strategies to improve its long-term effectiveness are needed.Trial registrationAustralian New Zealand Clinical Trials Registry, https://www.anzctr.org.au ACTRN12617000514303.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"1260-1269"},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Teledermoscopic triage of melanoma-suspicious skin lesions is safe: A retrospective comparative diagnostic accuracy study with multiple assessors.","authors":"Gustav Gede Nervil, Niels Kvorning Ternov, Henrik Lorentzen, Charles Kromann, Åsa Ingvar, Kari Nielsen, Martin Tolsgaard, Tine Vestergaard, Lisbet Rosenkrantz Hölmich","doi":"10.1177/1357633X241286003","DOIUrl":"10.1177/1357633X241286003","url":null,"abstract":"<p><p>BackgroundThe rising incidence of melanoma and the high number of benign lesions excised due to diagnostic uncertainty highlight the need for effective patient triage. This study assesses the safety and accuracy of teledermoscopic triage on a high-prevalence case set with pre-triaged, challenging, melanoma-suspicious lesions.MethodsFive dermatologists independently reviewed 250 retrospectively extracted patient cases. Teledermoscopy assessments were simulated for panels of 1, 2, 3 and 5 assessors using two distinct consensus strategies, <i>Caution Protocol</i> and <i>Majority Vote</i>, and the sensitivity and specificity of the patient triages were calculated.ResultsTriage by a single teledermatologist showed a sensitivity of 92.3% and a specificity of 58.7%. Sensitivity improved with the number of assessors, particularly when using the <i>Caution Protocol</i>, though with a considerable drop in specificity. The <i>Majority Vote</i> showed a more balanced improvement in sensitivity and specificity. Safety analyses indicated that diagnostic accuracy decreased with poor image quality and increased case difficulty.DiscussionExpert teledermoscopic triage of melanocytic skin lesions is highly sensitive and lowers the need for unnecessary excision procedures by half while dismissing as few as 0.4% (95% confidence interval 0-0.6%) of melanomas, even when applied to a high-prevalence pre-triaged subpopulation. Implementation of safety procedures increases accuracy. Using multiple teledermatologists increases sensitivity but at the cost of specificity unless a <i>Majority Vote</i> consensus strategy is applied. Future teledermoscopy guidelines should encompass safety procedures and protocols for disagreement between assessors.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"1296-1307"},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telehealth physical examinations show comparable accuracy and results to clinical exams for MRI confirmed shoulder pathologies.","authors":"Mark A Glover, Kendall E Bradley, Peter M Casey, Chad Cook, Emily K Reinke, Emily N Vinson, Richard C Mather, Jonathan Riboh, Tally Lassiter, Jocelyn R Wittstein","doi":"10.1177/1357633X251375155","DOIUrl":"https://doi.org/10.1177/1357633X251375155","url":null,"abstract":"<p><p>IntroductionThe purpose of this study is to measure the comparative diagnostic accuracy of telehealth diagnostic examinations for pathologies of the shoulder against an in-person examination. The telehealth examinations were hypothesized to be non-inferior to in-person examinations for accuracy and to demonstrate fair to moderate agreement. This is an expanded study of a data set included in a prior publication.MethodsPatients underwent in-person standardized clinical examination (SCE) and standardized telehealth examination (STE) during the same visit by two different providers in randomized order. Tests were analyzed for sensitivity, specificity, agreement, and diagnostic accuracy using a nonarthrographic shoulder MRI as a reference standard, and divided into tests for rotator cuff tears (RCTs), glenohumeral arthritis (GHA), and acromioclavicular (AC) joint arthropathy. A pooled diagnostic accuracy was created for SCE and STE and directly compared using a Mann-Whitney <i>U</i> test.ResultsSixty-two patients, average age of 57.9 years (±11.2), with 60 patients obtaining an MRI, were included in this study. There were no significant differences in the pooled diagnostic accuracy of identifying RCT, GHA, or AC arthropathy between SCE and STE (<i>P</i> = .495, .469, .333, respectively). The highest agreement between SCE and STE was observed for the shoulder shrug test, night pain, and internal rotation limitation for identifying RCT.DiscussionSTE demonstrated non-inferior pooled diagnostic accuracy in comparison to SCE for full-thickness RCT, GHA, and AC joint arthropathy. Secondarily, there was moderate to substantial agreement for selective tests, with a considerable portion ranging from fair to substantial agreement.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"1357633X251375155"},"PeriodicalIF":3.2,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing validity and costs of virtual diagnostics for sleep disorders: A feasibility study.","authors":"Christoph P Beier, Anne Mette Ølholm, Gonçalo Nuno Bastos Dos Reis Morais, Ann Christine Waarkjær Olsen, Kristian Kidholm","doi":"10.1177/1357633X251372678","DOIUrl":"https://doi.org/10.1177/1357633X251372678","url":null,"abstract":"<p><p>IntroductionThe use of digital solutions including patient-reported outcomes is limited to follow-up of patients with established diagnoses but is rarely used as first step of the diagnostic process substituting a personal contact with a health professional. We report on the diagnostic validity and cost per patient implications based on a feasibility study of a new virtual diagnostic service (VDS) for common neurological sleep disorders that, as a first step, involves the collection and automated analysis of self-reported digital patient data.MethodsThe VDS was established at the Odense University Hospital, Denmark. Assessment of diagnostic validity of the underlying algorithm was conducted independently and blinded. Estimation of effects on cost per patient was based on administrative hospital cost data comparing similar periods before and after the introduction of VDS and estimates for travel and time consumption to assess the patients' economic benefits.ResultsA questionnaire-based algorithm was developed leveraging the diagnostic criteria of the American Academy of Sleep Medicine; comprehensibility was secured and improved by initial patient involvement. Parallel use of both the questionnaire and assessment by a senior sleep specialist of the first 20 patients revealed no discernible safety concerns and resulted in additional linguistic adaptions. The final questionnaire was completed by 123 of 157 patients (78.3%) identified as suitable for VDS. The questionnaire-based algorithm resulted in correct use of additional diagnostic procedures in 84 out of 95 patients with final diagnosis at data closure (88.4%, Cohen's kappa: 0.84). The algorithm proposed a specific diagnosis in 55 patients that was correct in 49.1% of cases (Cohen's kappa: 0.39). The economic analysis revealed a 46.7% reduction of the time from referral to diagnosis of the patient (226.5 days to 120.7 days). The average number of contacts with health professionals decreased from 2.15 to 1.26, the average direct costs per patients were reduced by 39.6% from 1811 Danish Kroner (DKK) to 1093 DKK. We estimated a 40.6% reduction of the total costs per patients from 3904 DKK to 2320 DKK including time consumption and travel costs.DiscussionThis first feasibility study indicates that use of digital diagnostic solutions as first step of the diagnostic process of neurological sleep disorders combined with an essentially complete virtual work flow has high accuracy and may be associated with reduced time for diagnostics and cost reductions for health providers and patients.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"1357633X251372678"},"PeriodicalIF":3.2,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telehealth-directed emergency tube thoracostomy.","authors":"Ben Aston, Benjamin Powell","doi":"10.1177/1357633X251372248","DOIUrl":"https://doi.org/10.1177/1357633X251372248","url":null,"abstract":"<p><p>In this case, we describe the remote telehealth leadership of emergent tube thoracostomy in a patient with a critical respiratory status. The patient had presented to a small rural health care facility with breathlessness and hypoxia despite supplemental oxygen. A subsequent chest x-ray revealed a large pneumothorax requiring emergent treatment to prevent respiratory demise. Due to their location, the arrival of a critical care team would be delayed, and the local staff had very limited prior experience with chest procedures. Through remote telehealth leadership, the local team was guided through initial attempts at the Seldinger tube thoracostomy technique, before progressing to an open approach following failure of the initial attempt. Ultimately, the patient was stabilised and remained admitted locally, avoiding aeromedical retrieval. Key learnings included the need to develop a shared mental model of the procedure, responding to local equipment limitations, the leadership response to initial technique failure, and maintenance of situational awareness. This furthers evidence provided in prior case reports that high acuity low occurrence critical care procedures can be facilitated via remote telehealth support.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"1357633X251372248"},"PeriodicalIF":3.2,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disparities in patient experience with video and audio-only virtual care.","authors":"Gideon Loevinsohn, Yizhou Cui, Lee H Schwamm, Kori S Zachrison","doi":"10.1177/1357633X251372682","DOIUrl":"https://doi.org/10.1177/1357633X251372682","url":null,"abstract":"<p><p>IntroductionThe rapid expansion of virtual ambulatory care has included both video and audio-only modalities. The impact of visit modality on patient experience is poorly understood, particularly in the interplay with social health determinants and technical aspects of virtual care. We sought to characterize differences in the patient-reported experience of virtual care between video and audio-only modalities, and to understand drivers of these differences.MethodsWe analyzed one year of ambulatory virtual visits with linked patient experience data from a US health system. Using nested logistic models, with a patient's likelihood to recommend the provider as the primary outcome, adjusting for patient- and physician-level covariates, we explored differences in experience by visit modality (video vs audio-only), including across demographic groups. We further assessed the impact of modality on patients' experience with technical aspects of virtual care.ResultsAmong 90,670 virtual encounters with patient experience data, 16% were audio-only. Compared with video-based encounters, audio-only visits were associated with lower likelihood to recommend overall (OR 0.75; 95%CI 0.70-0.80) and worse experience with many technical aspects. Black patients were more likely to have audio-only encounters and worse overall patient experience. This disparity persisted after adjusting for visit modality and was partly mediated by differences in perceived respectful provider communication and associated interpersonal aspects of care.DiscussionAudio-only virtual care remains central to ensuring access to care, but poses challenges for patient experience. Interventions and investments targeted at improving technical facets and provider communication are needed, particularly for ensuring equitable experience across racial groups.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"1357633X251372682"},"PeriodicalIF":3.2,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of the remote video-based SARAH program in individuals with rheumatoid arthritis: A randomized controlled single-blinded study.","authors":"Alper Ceylan, Eren Baskan, Israfil Inanc, Devrim Can Sarac, Ayten Ozkan, Nur Banu Karaca, Dilek Solmaz, Sercan Gucenmez, Servet Akar, Deniz Bayraktar","doi":"10.1177/1357633X251372681","DOIUrl":"https://doi.org/10.1177/1357633X251372681","url":null,"abstract":"<p><p>IntroductionTo investigate the effectiveness of the remote video-based Strengthening and Stretching for Rheumatoid Arthritis of the Hand (SARAH) exercise program in individuals with rheumatoid arthritis (RA) with wrist involvement.MethodsSeventy-three individuals were included in the study. Wrist joint position sense, wrist joint range of motion, wrist pain, wrist morning stiffness, subjective and objective hand function, grip strength, and disease-related health status were assessed at baseline and after 12 weeks. Following the baseline assessment, participants were randomly assigned into two groups as SARAH and Control. All participants maintained their pharmacological therapy. The SARAH group received SARAH exercise videos via a free messaging platform (WhatsApp Messenger) weekly and performed the program daily for 12 weeks. No additional intervention was provided to the control group.ResultsForty-nine individuals (SARAH group = 28, control group = 21) completed all study procedures. Both per-protocol and intention-to-treat (ITT) analyses showed significant improvements in all parameters in the SARAH group (<i>p</i> < 0.05), while no statistically significant changes were detected in the control group (<i>p</i> > 0.05). When the changes were compared between the groups, SARAH group showed greater improvements regarding the changes in wrist joint position sense, wrist flexion, extension (only in ITT analysis) and radial deviation joint range of motion, wrist pain, wrist morning stiffness duration (only in ITT analysis), hand function, grip strength, and disease-related health status compared to the control group (<i>p</i> < 0.05).DiscussionA 12-week remote video-based SARAH exercise program provides additional benefits in individuals with RA who present wrist related problems when added to pharmacological therapy.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"1357633X251372681"},"PeriodicalIF":3.2,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}