Telemedicine for Psoriatic Arthritis
(PsOWell Trial)
Recruiting in Palo Alto (17 mi)
+1 other location
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: University of Pennsylvania
Disqualifiers: Inability to consent, PsAID score ≤4, others
No Placebo Group
Approved in 3 Jurisdictions
Trial Summary
What is the purpose of this trial?
This will be a single-arm interventional study to test the acceptability, feasibility, and effectiveness of structured telemedicine visits to encourage lifestyle changes that will improve quality of life, disease impact, and disease activity in patients with psoriatic arthritis (PsA).
Do I have to stop taking my current medications for the trial?
The trial does not specify if you need to stop taking your current medications. However, you should be stable on your current therapy and not planning to switch treatments during the study.
What data supports the idea that Telemedicine for Psoriatic Arthritis is an effective treatment?
The available research shows that telemedicine can be effective for managing chronic conditions similar to Psoriatic Arthritis. For example, telehealth has been shown to improve care for patients with osteoarthritis and spinal pain by reducing pain intensity and disability. Additionally, telehealth has been beneficial for patients in remote areas with chronic neurological conditions by improving access to specialized care and reducing costs. These findings suggest that telemedicine could also be effective for Psoriatic Arthritis by providing better access to care and potentially improving patient outcomes.12345
What safety data exists for telemedicine in treating psoriatic arthritis?
The research does not provide specific safety data for telemedicine in treating psoriatic arthritis. However, it highlights the potential benefits of telemedicine, such as improved access to healthcare, early diagnosis, and better disease management. Challenges include difficulties in diagnosing PsA without in-person examinations. The studies focus on the effectiveness and feasibility of telemedicine, but specific safety data is not detailed.678910
Is telemedicine a promising treatment for psoriatic arthritis?
Yes, telemedicine is a promising treatment for psoriatic arthritis because it improves access to healthcare, allows for early diagnosis, and helps manage the disease more effectively. It can connect patients with specialists remotely, reducing delays in care and making it easier for patients to receive timely treatment.78111213
Eligibility Criteria
This trial is for adults aged 18-89 with active psoriatic arthritis symptoms, stable on current therapy, and not planning to change treatment soon. Participants must be willing to follow study procedures, have a mobile device for telemedicine visits, and score over 4 on the PsAID questionnaire or patient global assessment.Inclusion Criteria
I am willing and able to follow all study rules and attend all appointments.
I am not planning to change my current treatment plan.
Provision of signed and dated informed consent form
See 5 more
Exclusion Criteria
Inability to provide informed consent
My PsA symptoms are mild.
I plan to change my psoriasis or PsA treatment soon.
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Intervention
Participants engage in structured telemedicine visits using PsOWellTM to encourage lifestyle changes for holistic management of psoriasis
24 months
Regular telemedicine visits
Follow-up
Participants are monitored for safety and effectiveness after the intervention
4 months
Treatment Details
Interventions
- Telemedicine (Behavioral Intervention)
Trial OverviewThe study tests how well patients with psoriatic arthritis respond to structured telemedicine visits aimed at encouraging lifestyle changes. It will evaluate if these remote consultations can improve life quality and disease management effectively.
Participant Groups
1Treatment groups
Experimental Treatment
Group I: Interventional Telemedicine ArmExperimental Treatment1 Intervention
Single Arm Intervention
Telemedicine is already approved in United States, European Union, Canada for the following indications:
🇺🇸 Approved in United States as Telemedicine for:
- General medical consultations
- Chronic disease management
- Urgent care needs
🇪🇺 Approved in European Union as Telemedicine for:
- General medical consultations
- Chronic disease management
- Urgent care needs
🇨🇦 Approved in Canada as Telemedicine for:
- General medical consultations
- Chronic disease management
- Urgent care needs
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
University Of PennsylvaniaPhiladelphia, PA
University of UtahSalt Lake City, UT
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Who Is Running the Clinical Trial?
University of PennsylvaniaLead Sponsor
References
An Internet-Based Intervention for Cardiovascular Disease Management Integrated With Primary Care Electronic Health Records: Mixed Methods Evaluation of Implementation Fidelity and User Engagement. [2021]Growing evidence supports the benefits of eHealth interventions to increase patient engagement and improve outcomes for a range of conditions. However, ineffective program delivery and usage attrition limit exposure to these interventions and may reduce their effectiveness.
A physical therapist and nurse practitioner model of care for chronic back pain using telehealth: Diagnostic and management concordance. [2022]Virtual care using videoconference links between urban-based physical therapists and nurse practitioners in rural primary care may overcome access challenges and enhance care for rural and remote residents with chronic low back disorders (CBD). The purpose of this study was to evaluate the concordance of this new model of care with two traditional models.
The application of telehealth to remote and rural Australians with chronic neurological conditions. [2021]Patients with chronic disease in rural and remote regions endure limited access to specialised medicine. Telehealth has addressed this issue with demonstrable benefits such as a reduction in costs to patients.
Effectiveness of telephone-based interventions for managing osteoarthritis and spinal pain: a systematic review and meta-analysis. [2022]Osteoarthritis and spinal pain are common and burdensome conditions; however, the majority of patients with these conditions do not receive care that is consistent with clinical practice guidelines. Telehealth models of care have the potential to improve care for osteoarthritis and spinal pain patients. The aim of this review was to assess the effectiveness of verbal real-time telehealth interventions, including telephone-based and videoconferencing interventions to reduce pain intensity and disability in patients with osteoarthritis of the knee or hip and spinal pain (back or neck pain).
Effect of Internet-Based Rehabilitation Programs on Improvement of Pain and Physical Function in Patients with Knee Osteoarthritis: Systematic Review and Meta-analysis of Randomized Controlled Trials. [2021]Osteoarthritis (OA) is a chronic, debilitating, and degenerative joint disease. However, it is difficult for patients with knee OA to access conventional rehabilitation when discharging from the hospital. Internet-based rehabilitation is one of the promising telemedicine strategies to provide a means combining monitoring, guidance, and treatment for patients with knee OA.
Apremilast Adherence and Persistence in Patients with Psoriasis and Psoriatic Arthritis in the Telehealth Setting Versus the In-person Setting During the COVID-19 Pandemic. [2023]Limited access to healthcare during the COVID-19 pandemic prompted patients to seek care using telehealth. In this study, we assessed whether treatment patterns differed for patients with psoriasis (PsO) or psoriatic arthritis (PsA) initiating apremilast by either a telehealth or an in-person visit.
Telemedicine and psoriatic arthritis: best practices and considerations for dermatologists and rheumatologists. [2022]Telemedicine encompasses a variety of modalities that allow for the remote assessment and treatment of patients. The technologies, services, and tools available for telemedicine in the USA are increasingly becoming an integral part of the healthcare system to bridge the gaps in care that can arise from geographic and/or socioeconomic obstacles and provider shortages. Telemedicine can be applied to a spectrum of clinical areas, including rheumatic diseases. Psoriatic arthritis (PsA) is a chronic, inflammatory, multisystem disease with predominately skin and joint manifestations. PsA is often misdiagnosed and/or undiagnosed, which can lead to worse patient outcomes, including irreversible joint erosion and damage. The difficulties in diagnosing and managing PsA are confounded by the emergence and increased use of telemedicine because of the COVID-19 pandemic. Telemedicine presents the opportunity to increase access to healthcare by rheumatologists and dermatologists to improve training and education regarding PsA and to decrease time attributed to office visits associated with PsA. However, challenges in diagnosing PsA without a thorough in-person physical examination by a trained rheumatologist or dermatologist exist. We provide an overview of the ways telemedicine can be incorporated into clinical care and optimized for patients with PsA; characteristic clinical features of PsA, with a focus on skin and joint signs and symptoms; screening tools to be used in routine clinical care; assessments that can be used to evaluate quality of life, functional ability, and disease activity in PsA; and resources and recommendations for the development of future telemedicine use in rheumatology and dermatology. Key Points • Patients with psoriatic arthritis (PsA) are often misdiagnosed and/or undiagnosed. • Telemedicine can improve access to healthcare by rheumatologists and dermatologists. • Telemedicine can be incorporated into clinical care and optimized for managing PsA.
Digital Approaches for a Reliable Early Diagnosis of Psoriatic Arthritis. [2021]Psoriatic arthritis (PsA) is a chronic inflammatory disease that develops in up to 30% of patients with psoriasis. In the vast majority of cases, cutaneous symptoms precede musculoskeletal complaints. Progression from psoriasis to PsA is characterized by subclinical synovio-entheseal inflammation and often non-specific musculoskeletal symptoms that are frequently unreported or overlooked. With the development of increasingly effective therapies and a broad drug armamentarium, prevention of arthritis development through careful clinical monitoring has become priority. Identifying high-risk psoriasis patients before PsA onset would ensure early diagnosis, increased treatment efficacy, and ultimately better outcomes; ideally, PsA development could even be averted. However, the current model of care for PsA offers only limited possibilities of early intervention. This is attributable to the large pool of patients to be monitored and the limited resources of the health care system in comparison. The use of digital technologies for health (eHealth) could help close this gap in care by enabling faster, more targeted and more streamlined access to rheumatological care for patients with psoriasis. eHealth solutions particularly include telemedicine, mobile technologies, and symptom checkers. Telemedicine enables rheumatological visits and consultations at a distance while mobile technologies can improve monitoring by allowing patients to self-report symptoms and disease-related parameters continuously. Symptom checkers have the potential to direct patients to medical attention at an earlier point of their disease and therefore minimizing diagnostic delay. Overall, these interventions could lead to earlier diagnoses of arthritis, improved monitoring, and better disease control while simultaneously increasing the capacity of referral centers.
Retrospective evaluation of patient profiling and effectiveness of apremilast in an Italian multicentric cohort of psoriatic arthritis patients. [2020]We aimed to evaluate the baseline characteristics, the reasons for prescription, and the effectiveness/safety profile of real-life apremilast for the treatment of psoriatic arthritis (PsA).
Feasibility, effectiveness and patient satisfaction of telerehabilitation after thumb carpometacarpal arthroplasty and reverse total shoulder arthroplasty: A pilot study. [2023]Telemedicine is an effective, emerging interface to connect practitioners with patients. It facilitates access to healthcare expertise, reduces costs, time demands and health disparities while improving satisfaction. This pilot study evaluated the feasibility, effectiveness and patient satisfaction of telerehabilitation for thumb carpometacarpal (CMC) arthroplasty and reverse shoulder arthroplasty (rTSA).
Use of telemedicine during the COVID-19 pandemic in patients with inflammatory arthritis: a retrospective study on feasibility and impact on patient-reported outcomes in a real-life setting. [2023]Close follow-up is mandatory in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS). During the Coronavirus Disease 2019 (COVID-19) pandemic, rheumatological care was rapidly reorganized during the first peak from March 1, 2020 to May 31, 2020, and all patients with RA, PsA, and AS being treated with a subcutaneous biologic disease-modifying anti-rheumatic drug or oral targeted synthetic disease-modifying anti-rheumatic drug were followed remotely. A retrospective database analysis of these 431 patients before and after this period is presented herein. A rheumatologist directly contacted all patients by telephone. Patients could also enter data on patient-reported outcomes remotely using the digital platform iAR Plus. General health (GH) and visual analog scale (VAS) pain were the main outcomes along with FACIT and disease-specific questionnaires (RADAI, ROAD, PROCLARA for RA, and BASDAI, BASGI, BASFI for AS). In all, 449 visits were postponed (69.9% of all scheduled visits); telephone evaluation was deemed inadequate in 193 instances, and patients underwent a standard outpatient visit. Comparing patients on telemedicine to those who underwent hospital visits, we found no statistically significant differences in GH (35.3 vs 39.3; p = 0.24), VAS (33.3 vs 37.1; p = 0.29), or other specific outcome measures in patients with RA, PsA, or AS. These results show that telemedicine has undoubted benefits, and in light of the ongoing COVID-19 pandemic, it is likely that many patients with these diseases may prefer it.
Psoriatic arthritis. [2005]Psoriatic arthritis is an inflammatory arthritis associated with psoriasis. It can be difficult to diagnose and symptoms might vary from being mild to chronic and progressive. Julie Holdsworth discusses the objectives of care management for patients with psoriatic arthritis and explains the rationale for the drugs used to treat this disease.
National Psoriasis Foundation Telemedicine Task Force guidance for management of psoriatic disease via telemedicine. [2023]Telemedicine emerged as an alternative care delivery system used to offer effective long-term management to patients with chronic, inflammatory conditions such as psoriatic disease. Teledermatology can provide reliable clinical information through thorough history-taking and virtual evaluations that include patient-provided images and disease activity assessment tools that may help accurately diagnose and manage patients with psoriasis. The integration of validated screening tools for psoriatic arthritis and effective teledermatology practices may improve access to specialists, thus avoiding preventable delays in the diagnosis and treatment of patients with psoriatic arthritis. Although the provision of telehealthcare should not completely replace high quality, in-person dermatologic or rheumatologic visits, the convenience and collaborative nature of teledermatology may lead to expanded access and expedited care in the appropriate setting, whether it be in a virtual or in-person visit.