Patient reported outcomes with remote orthopaedic consultations by telemedicine: A randomised controlled trial

• Published in: Journal of Telemedicine and Telecare
• Main Authors: Buvik, Astrid, Bugge, Einar, Knutsen, Gunnar, Småbrekke, Arvid, Wilsgaard, Tom
• Format: Article in Journal/Newspaper
• Language: English
• Published: SAGE Publications 2018
• Subjects: Norway; North Norway
• Online Access: http://dx.doi.org/10.1177/1357633x18783921; http://journals.sagepub.com/doi/pdf/10.1177/1357633X18783921; http://journals.sagepub.com/doi/full-xml/10.1177/1357633X18783921

Introduction Decentralised services through outreach clinics or modern technology reduce patient travel time and cost to society. Telemedicine consultation through videoconference is one such modality. Here, we compared patient-reported health outcomes and satisfaction between video-assisted remote and standard face-to-face orthopaedic consultations. Methods This randomised controlled trial included two parallel groups: (1) patients receiving video-assisted remote consultation at a regional medical centre (RMC); and (2) patients receiving standard consultation at the orthopaedic outpatient clinic of the University Hospital of North Norway (UNN). This study included patients referred to or scheduled for a consultation at the orthopaedic outpatient clinic. After each consultation, patient satisfaction was determined using patient-completed questionnaires containing questions on patient-reported health (three-level European quality of life five-dimension index (EQ-5D-3L)/European quality of life visual analogue scale (EQ-VAS)) and questions from a validated OutPatient Experiences Questionnaire (OPEQ). Results This study included 389 patients, of which 199 received remote consultation and 190 received standard consultation (total of 559 consultations). In all, 99% RMC-randomised patients and 99% UNN-randomised patients evaluated the consultation as very satisfactory or satisfactory. Moreover, 86% RMC-randomised patients preferred video-assisted consultation as the next consultation. No difference was observed in patient-reported health after 12 months between the two groups. EQ-5D index scores were 0.77 and 0.75 for RMC- and UNN-randomised patients, respectively ( p = 0.42). Discussion We did not observe any difference in patient-reported satisfaction and health (EQ-5D/EQ-VAS) between video-assisted and standard consultations, suggesting that video-assisted remote consultation can be safely offered to some orthopaedic patients. Moreover, a significantly high proportion of patients selected video-assisted remote ...