Background: Despite the promising potential of mixed healthcare models—integrating a hybrid approach that alternates between in-person visits and teleconsultations to enhance accessibility and flexibility in patient care—there is still much to understand about their practical implications. This study aimed to assess the impact of these different care models, including the hybrid model, on clinical outcomes and treatment adherence in patients with rheumatoid arthritis (RA) at a specialized care center in Bogotá, Colombia, between July 2020 and October 2021. While hybrid care models have demonstrated potential in improving efficiency, reducing costs, and minimizing unnecessary travel for patients, there is limited research specifically examining their effect on clinical outcomes and treatment adherence. By comparing these models, the study sought to address this gap in the literature and provide valuable insights into the feasibility and effectiveness of hybrid healthcare approaches in the management of RA.

Objectives: • Evaluate clinical outcomes in rheumatoid arthritis (RA) patients treated through in-person consultations, teleconsultations, and a hybrid care model at a specialized care center in Bogotá, Colombia. • Analyze treatment adherence in RA patients under the different care models (in-person, teleconsultation, and hybrid model) during the study period. • Compare clinical efficacy across the three care models in terms of symptom control, disease progression, and quality of life in RA patients.

Methods: This was a quantitative, observational, analytical, and prospective cohort study designed to evaluate clinical outcomes in RA patients managed through in-person consultations, teleconsultations, or a mixed care model. Patients were followed up at 3, 6, and 12 weeks, as well as at 15 months, with assessments conducted using various tools. Disease activity was measured with the Patient Activity Scale (PAS) score across all care models, while the Disease Activity Score-28 (DAS28) was assessed exclusively during in-person visits. Quality of life was evaluated using the EuroQol 5-Dimension (EQ-5D) quality of life assessment, including the visual analogue scale (VAS) global, VAS score, and EQ-5D Time Trade-off (TTO) score. Physical function was assessed using the Health Assessment Questionnaire (HAQ), while treatment adherence was evaluated with the Morisky Green Levine (MGL) medication adherence scale. Additionally, self-care agency was measured using the Appraisal of Self-Care Agency (ASA) scale.

Results: Data were collected from 156 patients (85% women), including 40 managed via teleconsultation, 13 through in-person consultations, and 103 using a mixed care model. The most prevalent comorbidities were hypertension (35.3%) and diabetes (7.69%). Significant differences were found across consultation models for the following scales: global VAS (p=0.0032), PAS Score (p=0.0312), and HAQ (p=0.0088). The mixed care group exhibited intermediate scores compared to the other groups, with lower scores observed in the teleconsultation group and higher scores in the in-person care group. Conversely, no significant differences were observed between consultation models for the pain VAS scale (p=0.1019), EQ-5D VAS Global (p=0.78), EQ-5D VAS Score (p=0.7846), EQ-5D TTO Score (p=0.7659), Appraisal of Self-Care Agency (ASA) (p=0.6443), Morisky Green Levine medication adherence scale (p=1.000), or DAS-28 (p=0.8395).

Conclusion: Overall, the mixed care model for patients with RA shows no major differences compared to in-person or teleconsultation models. When differences are observed, the mixed model demonstrates intermediate outcomes relative to the other groups. Further studies with larger sample sizes and diverse populations across Colombia and Latin America are needed to validate these findings.

REFERENCES: [1] Santos-Moreno P, Rodríguez-Vargas GS, Casanova R, Rubio-Rubio JA, Chávez-Chávez J, Rivera-Triana DP, Castiblanco-Montañez RA, Hernández-Zambrano SM, Villareal L, Rojas-Villarraga A. Evaluation of a Non-Face-to-Face Multidisciplinary Health Care Model in a Population with Rheumatoid Arthritis Vulnerable to COVID-19 in a Health Emergency Situation. Healthcare (Basel). 2021 Dec 17;9(12):1744. doi: 10.3390/healthcare9121744. PMID: 34946471; PMCID: PMC8701032.

Acknowledgements: NIL.

Disclosure of Interests: None declared.

© The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.