Telehealth for Psoriatic Arthritis During COVID-19

What It Is, Research in PsA Care, Use, and More

If you have psoriatic arthritis (PsA), you might be worried about how to protect yourself during the COVID-19 pandemic. Healthcare is evolving to prevent further spread of the virus as well as any pathogens that may circulate in the future.

For people with PsA and others who face a higher risk of getting COVID-19 or for disease complications, telemedicine is a viable alternative to managing your health while staying home and practicing social distancing.

When telehealth—also known as telemedicine—started out, it was a means to give healthcare access to everyone regardless of where they reside. Now, with the COVID-19 pandemic, telehealth is being utilized as a matter of necessity to prevent the spread of the virus, especially to those most vulnerable. 

Here is what you need to how about using telehealth during the current health crisis and its benefit to people with PsA.

Telehealth call with doctor
filadendron / E+ / Getty Images 

What Is Telehealth?

Telehealth started more than 50 years when hospitals started to experiment with ways to reach people in rural and remote areas. With rapid technology changes over the last couple of decades, telehealth has become a complex and integrated service used by hospitals, nursing homes, private doctor offices, and other healthcare facilities.

Telemedicine continues to grow and change at a rapid pace. For example, the technology doctors use to communicate with patients includes live video conferencing technologies, which most people know how to use (like Skype or Facetime), and most people have access to a computer or mobile device in order to use these services.

With the COVID-19 health crisis, telehealth has made it easier for doctors to treat their patients and for patients to have access to their doctors. It has become an effective way to safely provide healthcare, including routine appointments like wellness visits, medication consults, follow-ups for ongoing care, dermatology, mental health therapy, and more.

Research on PsA and Telemedicine

While treating and managing PsA is different via video chat than in person, you can still great healthcare via telemedicine. And this is especially vital while we deal with a worldwide health crisis.

Anyone can get COVID-19 if exposed to coronavirus, but people some are more likely than others to become severely ill, require hospitalization, intensive care, or a ventilator, or die from complications of the disease.

People who are particularly susceptible to complications of COVID -19 are the elderly and people with underlying conditions, including those with compromised immune systems and/or who use immune system weakening medicines, such as is the case for people with PsA.

Research shows telemedicine can be a reasonable option for treating people with PsA. In a study reported in 2020, doctors out the University of Naples Federico II converted their rheumatology practice for their PsA patients using biologic drugs or Janus kinase (JAK) inhibitor drugs to a tele-rheumatology clinic for a 7-week period starting in March 2020.

During that time period, 105 telehealth appointments (by telephone or video) were conducted. The doctors were able to make medication adjustments for patients experiencing pain in the joints or entheses—sites of attachment for tendons, ligaments, facia, or capsules of bones.

They made patient care decisions by relying on photographs and medical history provided by patients. Of the patients who had disease changes and needed medication modifications, they attended in-person follow-ups the following day or the same day of the telehealth visit.

The researchers concluded the use of telemedicine can be a valuable tool that allows for social distancing for all parties involved—medical staff and their vulnerable patients.

Why Switch to Telehealth

The need to stay home to avoid exposure to COVID-19 might make it harder to get in to see your rheumatologist or dermatologist or to get necessary testing. And right now, many healthcare providers are only taking patients who have an urgent reason to come into their offices and who do not show any signs of COVID-19.

Symptoms of COVID-19 include fever (usually above 100.4 degrees), chills, cough, shortness of breath or difficulty breathing, fatigue, muscle and body aches, headache, a new loss of taste or smell, sore throat, congestion, or a runny nose, nausea or vomiting, and diarrhea. You do not need to experience all these symptoms to have the virus and symptoms vary from person to person.

Telehealth doesn’t mean you don’t need routine care to keep your PsA managed. It just means your doctor’s office is working to evolve and adapt to the changing medical landscape by using a safe, accessible, and cost-effective alternative so that you can get the medical care you need.

Safe and Accessible

Until the COVID-19 pandemic is over, you may want to take advantage of the telemedicine services your doctor’s office offers. We all need to work to protect ourselves and others during this time and staying home helps you stay healthy and reduces the number of infections in your community.

Meeting with your healthcare provider by telephone or by video can give you access to medical care in a convenient and easily accessible manner. Even with follow-up, telehealth is an easier option. Additionally, it removes barriers like having to find transportation or childcare, scheduling conflicts, and mobility problems.

Reduced Costs

Research shows telehealth is cost-effective, especially for diagnosis and management of inflammatory, autoimmune, and rheumatic diseases.

A systematic review of studies reported in 2017 by the journal Arthritis Care & Research looked at telemedicine studies for treating conditions like psoriatic arthritis. A number of studies reviewed included some type of cost analysis, and all of these found telemedicine to be cost-effective.

In addition to reducing your medical costs, your access to telemedicine could mean that you may not have future hospital stays. After all, if you are able to communicate with your doctor in a timely and convenient manner, problems can be addressed before they get worse.

A study reported in 2015 by The American Journal of Managed Care found people who took advantage of telemedicine services had 38% fewer hospital stays and 31% fewer hospital readmissions. The study participants were also 63% more likely to spend fewer days in the hospital. The researchers also found people who took advantage of telehealth were more likely to be engaged in their healthcare.

Additionally, telehealth services can reduce transportation costs, lost income from missing work, or childcare costs—costs you may incur had you gone to an in-office medical appointment.

How to Switch to Telehealth

To participate in telehealth, contact your doctor’s office when you need to make an appointment and ask if they are using telemedicine technology. If they are, they will provide you with an app or link to download or link to a telehealth program. When your appointment time comes, you and your doctor will log into the telehealth app and talk over a video connection.

Most of these platforms are safe to use, secure, and compliant with the Health Insurance Portability and Accountability Act (HIPAA). HIPAA is the federal law that protects your health information and privacy.

While video conferencing allows for better communication and interactions between you and your doctor, if you are not comfortable with a video visit or don’t have a supporting device, you can ask your doctor for a telephone consult.

Regardless of what telemedicine options you use, telehealth appointments do work well and are the best alternative until in-person medical care visits can resume.

Prepare for Telehealth Appointments

Even though your telehealth appointment takes place from the comfort of your home, you will still want to prepare ahead of time so that you can get the most out of your appointment.

Ways to ensure you get the best care include:

  • Signing in in advance to the link or app so that you can contact the telehealth service provider for any technical help
  • Making sure you have all the information you need for an in-person appointment, including identification, an insurance card, your medication list, and a list (or photographs) of symptoms or other concerns
  • Making sure you attend your telehealth appointment in a place that is quiet and well-lit, and you have a strong internet connection
  • Being prepared with any questions, writing them down in advance and having them available during the telehealth appointment
  • Having a notepad and pen handy so you can write down your doctor’s responses to questions and notes about any information or instructions he or she gives you

It is important to be patient and flexible with using telehealth. While telemedicine isn’t a new concept, it has only become the norm in this new COVID-19 world. We are all learning to figure out what works and doesn’t work.

And technology can be hard to figure out and get used to. Give yourself extra time and if videoconference appointments don’t work for you, talk to your doctor about other options, including how you can be safe at in-person appointments. 

In-Person Follow-ups

While a telehealth appointment can work for a regular PsA check-in with your doctor, you may still need to visit your doctor’s office for an in-person appointment.

You may need to come in and see your doctor if:

  • You experience new or severe joint swelling or pain
  • You develop new symptoms, including skin symptoms
  • Your doctor wants to examine you in person
  • New testing is needed

If you need to see your doctor for an in-office visit, the Centers for Disease Control (CDC) recommend the following precautions:

  • Notify your healthcare provider about any instructions they have prior to your visit.
  • Check your temperature to make sure you don’t have a fever and that you don’t have any other symptoms of COVID-19 before you leave home. 
  • Cover your mouth and nose with a mask when you go out in public.
  • Do not touch your eyes, nose, or mouth, especially after touching high traffic surfaces like doorknobs.
  • Stay at least 6 feet away from others while inside and waiting in lines.
  • When making any payments using electronic devices at your doctor’s office, sanitize your hands right away.
  • Wash your hands with soap and water as soon as you get home.

Barriers and Solutions

There are limits when it comes to telehealth visits for managing your psoriatic arthritis.

Some healthcare providers use technology that requires a connection from an actual facility, such as an associated hospital, facilitated by a nurse or other staff member. These types of telehealth services are used in areas where rheumatology appointments are hard to get or out of the way for someone, i.e. if they live in a rural area.

Another barrier with telemedicine is that you still have to come out to a medical facility to do bloodwork or other testing or examination that cannot occur over a teleconferencing program. For these types of situations, you can save the in-person appointments for times where they are especially necessary.

A barrier for older adults in using telemedicine is a lack of technology and experience in technology needed for telehealth appointments.

A 2020 poll done by the Kaiser Family Foundation found 7 in 10 adults aged 65 years or older report having a computer, smartphone, or tablet with internet access, this in comparison to young adults, the majority of which have access to the internet and electronic devices.

Across the board in adults of all ages, the percentage of adults who used their electronic device for a telehealth appointment in the first two weeks of April 2020 was 11–12%.

A concern for many of the older adults was privacy, which made many reluctant to use telehealth technology. The easiest to overcome this concern is to actually use telemedicine. By doing so, many people actually find they are more comfortable with telehealth appointments over in-person doctor visits.

A Word From Verywell

It looks like telehealth is here for the long haul, but how extensively it will be used after the pandemic is over is yet to be known. For the time being at least, you will not be driving to doctor’s appointments, missing work, having to get childcare, and enduring long waits in waiting rooms.

This is the best way to stay healthy and reduce your risk of getting exposed to the coronavirus. And it allows the opportunity to better focus on managing the various aspects of living psoriatic arthritis at a time that is very stressful for everyone.

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