风湿病学远程医疗满意度与现场就诊满意度:一项非劣效性随机对照试验。

IF 20.3 1区 医学 Q1 RHEUMATOLOGY
Lesley E Jackson, Jinoos Yazdany, Justin M Leach, Kenneth G Saag, Kiara Aaron, Jeffrey R Curtis, Sarah Goglin, Mary Margaretten, David H Chae, Diana Paez, Gary Cutter, Maria I Danila
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引用次数: 0

摘要

目的:我们测试了风湿病远程医疗就诊在患者满意度和护理效果方面是否优于面对面就诊,包括年龄、性别、种族和民族、收入和就业状况等亚组。方法:该多中心非劣效性试验将患者随机分为1次面对面或远程医疗就诊。主要结果是高访问满意度的比例(在0-10量表中为9或10)。初步分析测试了患者对远程医疗的满意度是否不逊于现场护理(10%的非劣效裕度)。次要和探索性结果包括对下次就诊类型的偏好、亚组满意度和免疫抑制剂毒性监测。我们进行了改良的意向治疗(mITT)和每个方案分析。结果:在651例随机患者中(面对面,n = 323;远程医疗n = 328), 500人(76.8%)就诊定义了mITT人群。远程医疗满意度不低于现场医疗满意度;77.0%远程医疗,90.1%面对面,差异13.1% (90% CI, 7.7%-18.5%)。各方案分析结果一致。与远程医疗组相比,面对面组中更多的参与者在下次就诊时更倾向于相同的就诊类型,而不是不同的就诊类型/没有偏好(55.6%面对面,19.1%远程医疗,P < 0.0001, mITT分析)。男性对两种访视方式的满意度相同(90.0%),而女性对亲自访视更满意(90.2%对74.7%)。现场毒性监测率高于远程医疗(例如,肝功能:92.1%对66.3%,P = 0.0001,按方案分析)。结论:在大量不同类型的患者中,远程医疗的满意度并不低于风湿病就诊。更多的参与者更喜欢在mITT和每个协议分析中亲自访问。适当的毒性监测在远程医疗组低于现场组。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Satisfaction with telemedicine versus in-person visits in rheumatology: a noninferiority randomised controlled trial.

Objectives: We tested whether a rheumatology telemedicine visit was noninferior to an in-person visit for patient satisfaction and care effectiveness, including for subgroups of age, sex, race and ethnicity, income, and employment status.

Methods: This multicenter noninferiority trial randomised patients to 1 in-person or telemedicine visit. The primary outcome was the proportion of high visit satisfaction (9 or 10 on a 0-10 scale). The primary analysis tested whether patient satisfaction with telemedicine was noninferior to in-person care (10% noninferiority margin). Secondary and exploratory outcomes included preference for next visit type, satisfaction in subgroups, and immunosuppressant toxicity monitoring. We performed modified intent-to-treat (mITT) and per-protocol analyses.

Results: Among 651 randomised patients (in-person, n = 323; telemedicine n = 328), 500 (76.8%) had a visit defining the mITT population. Satisfaction with telemedicine was not noninferior to in-person; 77.0% telemedicine, 90.1% in-person, difference 13.1% (90% CI, 7.7%-18.5%). Per-protocol analysis results were consistent. More participants in the in-person group compared with those in telemedicine preferred the same visit type for their next visit vs a different visit type/no preference (55.6% in-person, 19.1% telemedicine, P < .0001, mITT analysis). Men were equally satisfied with both visit types (90.0%), while women were more likely to be satisfied with in-person visits (90.2% vs 74.7%). Toxicity monitoring rates were higher in in-person vs telemedicine (eg, hepatic function: 92.1% vs 66.3%, P = .0001, per-protocol analysis).

Conclusions: Among a large group of diverse patients, satisfaction with telemedicine was not noninferior to in-person rheumatology visits. More participants preferred in-person visits in the mITT and per-protocol analyses. Appropriate toxicity monitoring was lower in telemedicine vs in-person groups.

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来源期刊
Annals of the Rheumatic Diseases
Annals of the Rheumatic Diseases 医学-风湿病学
CiteScore
35.00
自引率
9.90%
发文量
3728
审稿时长
1.4 months
期刊介绍: Annals of the Rheumatic Diseases (ARD) is an international peer-reviewed journal covering all aspects of rheumatology, which includes the full spectrum of musculoskeletal conditions, arthritic disease, and connective tissue disorders. ARD publishes basic, clinical, and translational scientific research, including the most important recommendations for the management of various conditions.
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