Patient satisfaction in a new model of nurse- and pharmacist-led virtual monitoring clinic in rheumatology practice

We aimed to evaluate patient satisfaction of a model of allied health led telemedicine in rheumatology clinic during and beyond COVID-19 pandemic. A new model of enhanced virtual monitoring clinic (eVMC) led by trained allied care professionals with prescription rights was set up and expanded in 2019 for a variety of rheumatic diseases. In this cross-sectional study, we recruited participants who attended the eVMC via emails, text messages or in outpatient clinic. We assessed patient satisfaction using the validated Client Service Questionnaire-8 (CSQ-8). Variables associated with patient satisfaction were evaluated using generalised linear regression models. We asked participants of reasons they liked or disliked about eVMC and their willingness to continue eVMC. Of 433 participants (64.4% female, mean age 56.1 years), patient satisfaction was high with a mean (standard deviation, SD) total CSQ-8 score of 25.9 (SD = 4.6) out of 32. Higher education (ß=1.75, 95% CI: 0.49, 3.01; p = 0.006) and stable rheumatological condition (ß=2.30, 95% CI: 0.98, 3.61; p = 0.001) were associated with higher patient satisfaction. The top three reasons participants favouring eVMC during COVID-19 pandemic were time saved from travelling, reduced risk of infection and convenience of medicine delivery services. 82.9% of participants expressed willingness to continue eVMC after COVID-19 pandemic. We described a new model of telemedicine led by trained allied health professional that has become an indispensable part of rheumatology care beyond COVID-19 pandemic. Rheumatology outpatients expressed a high level of satisfaction with the eVMC. Higher education and stable disease were associated with patient satisfaction. We describe the setup of a telemedicine model of care led by specially trained allied health professionals in rheumatology outpatient clinic. We demonstrated the feasibility and good patient satisfaction in this model of care during COVID-19 pandemic. Over 80% of patients expressed willingness to continue the model of care after COVID-19 pandemic and has become an indispensable part of rheumatology care. Higher education and perceived stable disease are key factors associated with patient satisfaction and may give important insight for appropriate patient selection to benefit from this telemedicine care model. We highlighted the success of the model of care being appropriate training of staff, supportive medicine delivery system and careful selection of patients who have higher educational attainment, having less complex and more stable disease to the care model.