Many patients can be followed up with fewer checks
A new study shows that both digital home follow -up and patient -controlled follow -up can save health resources, without compromising patient safety or satisfaction. It can provide more flexible and effective health services for patients with chronic illness.
Professor Nina Østerås led the randomized, controlled study at Diakonhjemmet Hospital. Many patients with chronic illness are regularly called to the specialist health service for follow -up. Østerås explains that digital home follow -up and patient -controlled follow -up are increasingly used in health services.
This is the first study that systematically examines how a digital and a patient -controlled model work for patients and health professionals.
- Many introduce new, digital follow -up models without first examining their effect. We wanted to find out if two new follow -up models were equally good at controlling the disease compared to the patients being regularly called in to hours in the hospital, controlled by a calendar, explains Østerås.
The study is now published in the renowned journal, Annals of the Rheumatic Diseases, https://ard.eular.org/article/s0003-4967(25)0090908-2/fulltext
New models for follow -up were equally good for patients
A total of 243 patients, with the rheumatic disease axial spondyloarthritis, participated in the study in the period 2021 to 2023. The vast majority were at work, and the disease was in a peaceful phase when the study started. Patients were randomly distributed to follow up either digitally, according to their own needs or by fixed, regular checks.
- After 18 months, the results were equal in all three groups when it came to treatment effect and patient safety, says Østerås.
Increased flexibility and saved resources
In the group of digital home follow -up, the need for follow -up was assessed on the basis of patients' monthly reporting on ailments from the disease, via an app. If the reports suggested increased disease activity, the nurse contacted further assessment.
The patients in the group of patient -controlled follow -up had no permanently set control hours, but were asked to contact the nurse when worsening the disease. They were offered early medical time if they wanted it.
The group with traditional, regular follow -up received a summons to an hour, with attendance at the hospital, every six months.
The patients with patient -controlled follow -up had the least follow -up of health care professionals in the study. This means that they were in little need of control hours and had the fewest phone calls with health professionals.
The digital follow -up group also had little need for control hours, compared to those with regular, regular control hours. There were most short phone calls in the digital group, as a result of health care professionals contacting the patients' own reports in the app.
Nina Østerås says that the study showed that new strategies for follow -up can save patients time and resources. It can also free up time for health professionals, to other patients. The new models can therefore be good alternatives for following up people with chronic illness.
She emphasizes that digital home follow -up will require changes in how health professionals work. Stable and user -friendly technology is also important to get digital follow -up to work. - In addition, there should be financial incentives, so that hospitals prioritize investing in software in order to offer digital home follow -up, says Østerås.
Satisfied patients
The patients were satisfied with the follow -up they received, no matter which of the three models they followed.
Researcher and consultant in rheumatology, Inger Jorid Berg meets many of these patients in treatment at the hospital. - The study provided us with important knowledge in order to meet patients with more flexible, personalized and effective models to follow up on their chronic illness, she emphasizes.
The study also showed that many patients with axial spondyloarthritis can control their own follow -up. - Then it is important to be organized so that patients get an hour soon if the disease worsens. This is already the case at our outpatient clinic at Diakonhjemmet Hospital, says Dr. Berg.
Both digital and patient -controlled follow -up works fine when the disease is peaceful
Postdoctoral fellow Christine Hillestad Hestevik has the in-depth interview 18 of the patients who participated in the study.
- The patients said that both models for follow -up were satisfactory when their disease condition was well controlled, she summarizes.
The interviews also revealed that patients were motivated to rarer follow -up due to limited health care resources. They justified it with the desire to free up resources for other patients.
The patients also appreciated that the new models reduced the need to take time off from work and allowed them to move the focus away from the disease.
Some also appreciated the opportunity to take greater part of the responsibility for their own follow -up.
-Some were also skeptical about the quick progress of technology and preferred face-to-face meetings for emotional support and security in the follow-up, says Hestvik.
The interviews also revealed that technical challenges and lack of confidence in technology were important barriers to digital home follow -up.
Patients were positive to digital home follow -up
Emil Eirik Kvernberg Thomassen has been a doctoral fellow in the study. He has examined patients' attitude to regularly report digitally from home.
- Most patients were positive about testing digital home follow -up. They followed up well the regular reporting from home, throughout the period of 18 months, says Thomassen.
He adds that they saw a slight tendency for age, educational level, health literacy, physical function and work status to influence how positive they were to try digital home follow -up. However, these factors did not matter in relation to how well they followed up reporting in the app.
Funding and further research
The study is funded by research funding from Health South-East RHF and the Research Council of Norway. The researchers will now link the results in the study to data from national registers on health service consumption for further health economic analyzes.
Fact Box:
Remonit is a short version of the full name of the study: Remote Monitoring of Axial Spondyloarthritis in Specialist Healthcare Services
Axial spondyloarthritis is a chronic, rheumatic disease with pelvic and back inflammation, which causes stiffness and pain in the lower back. Pain and stiffness are often relieved by physical activity. The disease can cause inflammation in the second joints and tendons, as well as eye inflammation, bowel disease and psoriasis. Axial spondyloarthritis occurs in early adulthood, most often before the age of 45. Some patients are treated with immunosuppose drugs that effectively reduce pain and stiffness.
Read more about the Remonit study here : https://remedy-senter.no/project/remonit?highlight=wyjyzw1vbml0il0 =
Read the publications:
Link to the main study: https://ard.eular.org/article/s0003-4967(25)00908-2/fulltext
