The association between telemedicine and patient outcomes in osteoarthritis and inflammatory arthritis: a systematic review and meta-analysis of randomized controlled trials

Abstract

Background Osteoarthritis (OA) and inflammatory arthritis (IA) are prevalent chronic musculoskeletal disorders that cause persistent pain, functional impairment, and reduced quality of life. Telemedicine offers a potential strategy for long-term arthritis management, but the strength of the supporting evidence remains uncertain. This systematic review and meta-analysis evaluated the efficacy of telemedicine interventions in patients with OA and IA. Methods We searched PubMed, Embase, Cochrane Library, Web of Science, and WHO ICTRP up to 10 July 2026 for randomized controlled trials (RCTs). Two reviewers independently conducted study selection, data extraction, and risk-of-bias assessment using the RoB 2.0 tool. Random-effects meta-analysis was performed to calculate standardized mean differences (SMDs) with 95% confidence intervals (CIs) and 95% prediction intervals (PIs). The certainty of evidence was rated using the GRADE framework. Results Twenty-four RCTs enrolling 2,262 patients (1,568 with OA and 694 with IA) were included. Telemedicine was associated with improvements in pain (SMD = −0.66, 95% CI −1.00 to −0.32; 95% PI −1.90 to 0.58), quality of life (SMD = 0.42, 95% CI 0.12 to 0.71; 95% PI −0.60 to 1.44), WOMAC scores (SMD = −0.78, 95% CI −1.19 to −0.37; 95% PI −2.25 to 0.69), and self-efficacy (SMD = 0.47, 95% CI 0.06 to 0.89; 95% PI −1.04 to 1.98). All primary outcomes showed substantial heterogeneity (I2 > 75%), with 95% PIs that spanned the null value, indicating that the true effect in future studies could be zero or even negative. The self-efficacy finding lacked robustness in leave-one-out sensitivity analyses and was susceptible to the influence of individual studies. Evidence for IA was restricted to a small number of trials on rheumatoid arthritis and ankylosing spondylitis, and the overall certainty of evidence was rated very low to low. Conclusions Current evidence suggests an association between telemedicine and improved outcomes in arthritis, but these findings are exploratory and limited by low evidence certainty, marked heterogeneity, and wide prediction intervals. Evidence for IA is insufficient to draw definitive conclusions. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/view/CRD420261401824, PROSPERO CRD420261401824.