Integrating telemedicine into routine follow-up care for patients with endometriosis: a randomised pilot study on patient satisfaction and healthcare resource utilization

Endometriosis is a hormone-dependent chronic inflammatory disorder characterized by the ectopic presence of endometrial-like tissue. Given its chronic, potentially progressive nature, affected women often require multidisciplinary, long-term follow-up with regular consultations to monitor symptoms, treatment adherence, and therapeutic adjustments. Incorporating mobile health (mHealth) tools and e-consultations into gynecologic care pathways may modernize endometriosis management by facilitating timely communication, personalized monitoring, and greater patient autonomy. We conducted a prospective, single-center, randomized pilot trial in an endometriosis referral center to evaluate the effect of a mobile telemedicine application as an add-on to standard follow-up of women with endometriosis compared with standard care alone. The primary outcome was patient satisfaction, measured at study completion using the validated Client Satisfaction Questionnaire (CSQ-8) and a custom-designed, non-validated online satisfaction survey. Secondary outcomes were: healthcare resource utilization (number of additional or emergency consultations during the study period); changes in pain scores for dysmenorrhea, dyspareunia, dysuria, dyschezia, chronic pelvic pain, and shoulder pain; changes in treatment requirements; and quality of life assessed using the Spanish version of the Endometriosis Health Profile-30 (EHP-30) and EuroQol-5D. The follow-up period was 6 months. Sixty participants were randomized: 31 to the intervention group and 29 to the control group. CSQ-8 scores at the final visit did not differ significantly between groups (18.9 ± 3.57 vs. 18.8 ± 0.92; p = 0.946). However, although assessed using a non-validated survey, a significantly greater proportion of app users reported having effective tools for communication with physicians and considered provider response times adequate (survey response rate 64.5% (20/31) in the intervention group and 75.9% (22/29) in the control group). The intervention group also had fewer additional or emergency consultations for endometriosis-related issues (16.1% vs. 44.8%; p = 0.032). No significant differences in pain or quality-of-life scores were observed between groups. In our study, adding a mobile telemedicine application to standard endometriosis follow-up did not improve patient reported satisfaction. However, exploratory findings suggested better patient-perceived communication with healthcare professionals, and the intervention was associated with fewer additional consultations. These findings suggest that mHealth-based telemedicine strategies may support patient-centered care, strengthen continuity of care, and contribute to a more efficient use of healthcare resources in chronic gynaecological conditions. Clinical trial registration NCT06976957; https://clinicaltrials.gov/study/NCT06976957. Registration date : 19 Dec 2023. In this randomized pilot study, a mobile telemedicine app for endometriosis follow-up did not improve patient reported satisfaction, although it improved communication and reduced reconsultation rates without improvements on pain or quality of life. That suggests potential benefits for patient management and healthcare resource optimization in this condition.