Patients and health workers were at high risk of infection during the Sars-Cov-2 pandemic lockdown. For this reason, other medical and clinical approaches such as Telemedicine were necessary. Despite Telemedicine was born before COVID-19, the pandemic was the opportunity to accelerate a process already underway for at least a decade and to blow all the barriers away. Our aim is to describe the experience of Telemedicine during and immediately after the first lockdown to assure the follow-up in a ‘virtual’ outpatient clinic dedicated to Rheumatic and Musculoskeletal Diseases (RMDs) and to give an overview of Telemedicine in the rheumatology field. We retrospectively evaluated the patient flow to our rheumatology division from March to September 2020 and, in accordance with local restrictions, three periods were selected. In the 1st period, 96.96% of the outpatient clinic cases were shifted to Telemedicine; these decreased to 52.45% in the 2nd period, while the 3rd period was characterized by the return of the patients at the clinic (97.6%). Diagnostic procedures were postponed during the 1st period, reduced drastically during the 2nd and performed regularly during the third period. Intravenous infusions were maintained as much as possible during the three periods, to assure therapeutic continuity. Shifting stable patients to Telemedicine has the potential to allow continuity of care, while reducing the risk of contagion during a pandemic. In the next future, the integration of Telemedicine as standard of care for specific clinical applications might assure assistance for RMDs patients also in non-pandemic conditions.

Rationale and aim: Health literacy (HL) is pivotal for the successful self-management of chronic diseases. Little HL information is currently available in SSc patients; therefore, the present study aims at evaluating the HL levels in an Italian cohort of SSc patients. Methods: SSc patients were enrolled with the support of Italian patient associations, from September 2022 to March 2023. Health literacy characteristics were derived from the Health Literacy Scale European Questionnaire-16 (HLS-EU-Q16), consisting of 16 items designed on a four-point Likert scale ranging from “very difficult” to “very easy”, and three HL levels were identified: inadequate HL (0–8 score); problematic HL (9–12 score); and sufficient HL (13–16 score). Results: Enrolled patients (n = 57, mean age = 59 years, SD = 13.2) were mostly female (98.2%), partnered (73.7%), and unemployed or retired (67.9%). Almost half of SSc patients were diagnosed more than 10 years ago, with first symptoms appearing on average 19 years ago (SD 10.5). In 63% of the participants, the overall health literacy skills were inadequate, or problematic, especially in the health care and disease prevention domains. Indeed, 49.2% of the patients declared difficulty in finding information on treatments for illnesses and where to get professional help (42.1%), 47.6% found difficulty in retrieving information on how to manage mental health problems, and 40.4% declared difficulties in judging whether the information on health risks in the media was reliable. Conclusions: Our findings show that SSc patients have inadequate or problematic levels of HL, suggesting the need for periodic screenings to uncover poor health literacy skills and to provide tailored and understandable educational material. This study was not registered.

Background: To meet the population's needs, community care should be customized and continuous, adequately equipped, and monitored.Introduction: Considering their fragmented and heterogeneous nature, a summary of community healthcare services described in European literature is needed. The aim of this study was to summarize their organizational models, outcomes, nursing contribution to care, and nursing‐related determinants of outcomes.Methods: A systematic review was performed by searching PubMed, CINAHL, Scopus, and Embase in October 2022 and October 2023 (for updated results). Quantitative studies investigating the effects of community care, including nursing contribution, on patient outcomes were included and summarized. Reporting followed the PRISMA checklist. The review protocol was registered on PROSPERO (CRD42022383856).Results: Twenty‐three studies describing six types of community care services were included, which are heterogeneous in terms of target population, country, interventions, organizational characteristics, and investigated outcomes. Heterogeneous services’ effects were observed for access to emergency services, satisfaction, and compliance with treatment. Services revealed a potential to reduce rehospitalizations of people with long‐term conditions, frail or older persons, children, and heart failure patients. Models are mainly multidisciplinary and, although staffing and workload may also have an impact on provided care, this was not enough investigated.Discussion: Community health services described in European literature in the last decade are in line with population needs and suggest different suitable models and settings according to different care needs. Community care should be strengthened in health systems, although the influence of staffing, workload, and work environment on nursing care should be investigated by developing new management models.Conclusions and implications for health policy: Community care models are heterogeneous across Europe, and the optimum organizational structure is not clear yet. Future policies should consider the impact of community care on both health and economic outcomes and enhance nursing contributions to care.

Background: Patients with Rheumatic and Musculoskeletal Diseases (RMDs) who are treated with Disease-Modifying Anti-Rheumatic Drugs (DMARDs) face an increased risk of infections. Therapeutic education is often considered a valuable strategy to support preventive behaviors, but its actual impact remains uncertain. Objectives: This scoping review aims to examine how therapeutic education contributes to infection prevention in patients with RMDs receiving DMARDs, with attention to its potential benefits, limitations, and relevance in clinical practice. Methods: Following the PRISMA-ScR framework, we searched PubMed, CINAHL, EMBASE, and Web of Science for primary studies published between January 1990 and December 2024 in English or Italian language. Eligible studies involved adult patients with rheumatic diseases treated with DMARDs who had received some form of therapeutic education. Results: Among 1591 records, only 4 studies met the inclusion criteria. These studies emphasized the value of promoting preventive behaviors to minimize treatment-related infections. Therapeutic education was associated with increased patient awareness and adherence, especially when supported by multidisciplinary healthcare teams. However, several barriers—such as limited health literacy and socioeconomic challenges—affected access and effectiveness. Discussion and Conclusions: While existing studies support the potential of therapeutic education and patient education in general, the small number of relevant studies and the variation in approaches limit strong conclusions on the impact of patient education on reducing or preventing risk infection in the field of rheumatology in DMARD-treated patients. Moreover, several papers pointed out how digital tools and telemedicine are promising ways to expand access and improve adherence, particularly for underserved populations. Thus, further research should explore standardized, inclusive and interdisciplinary strategies—potentially incorporating digital tools—to improve prevention and ensure equitable access to educational interventions.

The last name of the co-author, "Khadija El Aoufy", presented in the original published version of the above paper was incorrect. The last name should have been "El Aoufy" instead of "Aoufy". The author should be cited as "El Aoufy, K." The original article has been corrected.