Objectives To evaluate the experiences of patients with spondyloarthritis (SpA) and their healthcare providers (HCPs) with patient-initiated follow-up (PIFU) supported by asynchronous telemedicine (TM) compared with their previous experiences with usual care, and to identify prerequisites for sustainable implementation of PIFU/TM. Methods Individual, semi-structured interviews were conducted with purposefully selected patients (n = 21) and HCPs (n = 9) who previously participated in the ‘TeleSpA’ randomised controlled trial and thematically analysed. PIFU/TM consisted of a once-yearly pre-planned physical visit with in-between remote monitoring at 6 months. Additionally, 13 HCPs completed a quantitative survey, which was analysed descriptively. Results Most patients and HCPs found PIFU/TM acceptable, given the presence of sufficient health- and digital literacy and motivation. Most patients felt no burdensome changes to their personal responsibility, and both in-person and remote communication between stakeholders ran smoothly. Advantages for patients included time-savings, and improvements in disease insight and self-efficacy. Some HCPs experienced increased flexibility in their daily planning. Pivotal prerequisites for sustainable implementation were adequate infrastructure to conduct Ad hoc diagnostic tests, assured rapid access to the outpatient clinic when necessary, availability of technical and logistical support, and a user-friendly monitoring tool integrated with existing hospital information systems. Fine-tuning the design and delivery of questionnaires as part of TM is an opportunity for future research. Conclusion PIFU/TM was perceived as an acceptable approach for the follow-up of motivated patients with SpA with adequate health- and digital literacy. Preserved accessibility to the outpatient clinic and availability of ancillary support are essential for its sustainable implementation.

中文翻译：

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脊柱关节炎中异步远程医疗支持的患者发起随访的经验：一项混合方法研究


目的 评估脊柱关节炎 （SpA） 患者及其医疗保健提供者 （HCP） 在异步远程医疗 （TM） 支持的患者发起随访 （PIFU） 下与他们以前的常规护理体验相比的体验，并确定可持续实施 PIFU/TM 的先决条件。方法 对以前参加过“TeleSpA”随机对照试验的有目的地选择的患者 （n = 21） 和 HCP （n = 9） 进行个体、半结构化访谈并进行主题分析。PIFU/TM 包括每年一次预先计划的身体访问，中间在 6 个月时进行远程监控。此外，13 名 HCP 完成了一项定量调查，并对其进行了描述性分析。结果 鉴于存在足够的健康和数字素养和动机，大多数患者和 HCP 认为 PIFU/TM 是可以接受的。大多数患者觉得他们的个人责任没有沉重的变化，利益相关者之间的面对面和远程沟通都顺利进行。患者的优势包括节省时间，以及疾病洞察力和自我效能感的提高。一些 HCP 在日常规划中体验到了更大的灵活性。可持续实施的关键先决条件是足够的基础设施来进行临时诊断测试，确保在必要时快速进入门诊，提供技术和后勤支持，以及与现有医院信息系统集成的用户友好型监测工具。作为 TM 的一部分，微调问卷的设计和交付是未来研究的机会。结论 PIFU/TM 被认为是一种可接受的方法，用于随访具有足够健康和数字素养的积极性 SpA 患者。 保持门诊的可及性和辅助支持的可用性对于其可持续实施至关重要。