Telemedicine consultations in rheumatology

Purpose: Due to the coronavirus pandemic, adjustments were made to the standards for the provision of medical care to patients with rheumatological diseases, including an implementation of video consultations. The format of telemedicine services has its own characteristics in each country, largely dependent on how actively the Internet is used by the population. According to official data for 2018, Internet users in Russia accounted for 75.4% of the total population, while in the 55+ age group - only 36%. The aim of the study was to assess the development of telemedicine consultations (TMC) in the field of rheumatology in one of the medical offices in a large industrial center. Methods: The study included patients who applied for TMC. After it was held, all of them were asked to answer several questions in the Google form. The total number of participants was 36 patients. Results: A feature of the development of TMC was the extremely slow popularization of this method. Since the permission for this type of activity had been obtained, only 36 TMC were carried out in 5 months, while 488 traditional consultations have taken place. 77.8% of these were women, the overwhelming majority aged 31-50 years. 29 people lived in the immediate vicinity of the office, 3 - in the same region, but 4 people - in Russia up to 4000 km away from the office. About a quarter of the patients used online video consultations more than once. According to patients, 83.3% were able to completely, and 16.7% partially solve their problems. It was easy to establish contact for 86.1% of patients. The main reasons for applying for TMC were: it’s much faster than waiting in line for an in-person consultation, they just needed to clarify some issues (drug dose, control of analyzes). About half of the patients assessed the convenience of TMC (from home), the avoidance of infectious contacts in transport, and the quickness of urgent issues resolving. The main problems raised in the course of TMC were the routine control of laboratory tests and the correction of the therapy received. From this point of view, patients with gout and rheumatoid arthritis look the most promising for management. And, indeed, they constituted a significant part of those who applied for TMS. It’s remarkable that all patients noted their readiness to continue using TMC, since it turned out to be more convenient (100% of respondents' answers) due to the ability of receiving advice at a convenient time while staying at home, and the consultation is comparable to the face-to-face format (83.3%) in terms of quality;about half said that it saves time, and there is no problem of making an appointment with a doctor. For about a third of patients noted that this form of medical care is significantly cheaper than in-person visit. According to the doctor who conducted the consultations, 83.3% of patients were completely satisfied with the quality of this medical service and solved their problems. Conclusions: TMC represents a promising format of medical care for patients with rheumatic diseases.