# Comparison of Remotely Applied and Face-to-Face Disease Activity Scores in Saudi Arabian Patients With Rheumatoid Arthritis: A Prospective Cohort Study

## TL;DR

This study compared disease activity scores for rheumatoid arthritis patients in Saudi Arabia using phone calls versus in-person visits and found limited agreement and low satisfaction with the phone method.

## Contribution

The study evaluates the feasibility of telephone-based disease activity assessments for rheumatoid arthritis in a Saudi Arabian context.

## Key findings

- RAPID3 by phone showed moderate agreement with DAS28-ESR but low agreement with DAS28-CRP.
- Satisfaction rates with telephone-based assessments were low.
- 27% of patients were classified in remission or low disease activity by RAPID3.

## Abstract

Objectives: This study aimed to assess the disease activity indices (DAI) of rheumatoid arthritis (RA) by telephone-based tele-visits compared to face-to-face clinic encounters.

Methods: Patients with RA attending outpatient clinics between December 2021 and May 2022 were prospectively recruited. Disease activity assessments were initially performed in the clinic using the disease activity score 28-C-reactive protein (DAS28-CRP) and disease activity score 28-erythrocyte sedimentation rate (DAS28-ESR). Within two weeks of the clinic visit, a telephone-based assessment gathered information on demographics, Routine Assessment of Patient Index Data 3 (RAPID3) score, and satisfaction. Disease activity scores were dichotomized into remission or low disease activity and moderate to high disease activity.

Results: A total of 78 patients completed the two-point interview. Of those, 62 (79.49%) were women, with a mean age of 54.73±13.71 years. Seropositivity for rheumatoid factor and/or anti-citrullinated peptide was observed in 51 (83.61%) participants. Twenty-seven percent of the patients were classified as in remission or low disease activity by RAPID3. This was 71% for DAS28-CRP and 33% for DAS28-ESR. Based on the dichotomized disease activity classification, the agreement percentage between RAPID3 and DAS28-ESR was 78.08%, while it was 47.22% between RAPID3 and DAS28-CRP, which resulted in kappa statistic values of 0.48 (moderate agreement) and 0.14 (low agreement), respectively. Satisfaction rates were low.

Conclusion: Telephone-based RAPID3 showed a low-moderate agreeability compared to DAS28 and had low satisfaction rates. This suggests that tele-rheumatology care by this means was not feasible for following up with patients with RA and warrants further development.