Implementation of telemedicine and home medication dispensing for rheumatoid arthritis patients in Sicily: opportunities beyond the pandemic

The three groups had similar age distributions (anti-TNF-α: 64.2 ± 15.2 years; IL-6: 62.5 ± 14.8; co-stimulation modulator: 61.6 ± 14.6).Our preliminary results showed that patients who benefited from a home dispensation service reported better HAQ and DAS28-ESR values than patients who did not (HAQ anti-TNF-α: 2.3 ± 0.4; HAQ IL-6: 2.9 ± 0.3; HAQ costimulation modulator: 2.8 ± 0.3; DAS28-ESR anti-TNF-α: 3.1 ± 1.3; DAS28-ESR IL-6: 3.5 ± 1.4; DAS28-ESR co-stimulation modulator: 3.6 ± 1.4).The automatic renewal of the treatment plan, the possibility of electronically sending the exams, and the ability to virtually talk to patients improved patients' health conditions in the first group over the other two.These virtual contacts were mediated by the local general practitioner and were possible thanks to the collaboration between the prescribing centers and the territorial services.These results indicate that home dispensing service helped in complying with the treatment plan during the pandemic in Sicily (including 25 patients living in minor islands).It is quite possible that the different HAQ and DAS28-ESR scores resulted from different levels of adherence to therapy by patients who received their medication at home and those who had to pick it up at the hospital, a task extremely difficult at the time of the pandemic.In our opinion, the home medication dispensing service should be continued even after the pandemic since it would benefit all patients who would still have difficulty reaching the hospital.Telemedicine should be carefully implemented by selecting the most suitable patients, specifically those in remission or with a low disease activity.I believe that alternating home and hospital dispensing would allow us to plan a hospital visit every 8 months instead of 4 months, leading to a better balance between the clinical needs and the logistical necessities of patients and positively impacting their quality of life.Key message: Home medication dispensing in RA can positively impact therapeutic adherence and patients' quality of life.

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