Background The use of eHealth tools (eg, the internet, mobile apps, and connected devices) in the management of chronic diseases and for rheumatoid arthritis is growing. eHealth may improve the overall quality of care provided to patients with chronic diseases. Objective The primary objective of this study was to describe eHealth use by patients with rheumatoid arthritis in France. The secondary objectives were to identify associations between patient demographics and disease characteristics and the use of eHealth tools, and assess their expectations of eHealth. Methods In this cross-sectional, multicenter study, patients with rheumatoid arthritis, according to the 2010 ACR/EULAR classification criteria, were recruited from 5 university hospitals (Bordeaux, Clermont-Ferrand, Limoges, Montpellier, and Toulouse). Patients completed an anonymous self-questionnaire, including demographic data, evaluating their eHealth use (ie, access, support, frequency of use, type of use, and reason for use). The rheumatologist in charge of each patient completed an independent medical questionnaire on disease characteristics, activity of rheumatoid arthritis, and treatments. Data were collected between December 2018 and July 2019. Results Questionnaires were completed by 575 participants, with a mean age of 62 (SD 13) years, 447 (77.7%) of whom were female. Overall, 82.2% (473/575) of the participants had access to eHealth through a computer (402/467, 86.1%), tablet (188/467, 40.2%), or smartphone (221/467, 47.3%). Of these, 36.4% (170/467) of the participants used the internet for health in general, and 28.7% (134/467) used it specifically for rheumatoid arthritis–related reasons. All these 134 patients used eHealth to learn about disease pathology, and 66.4% (89/134) of them used it as a tool to help monitor rheumatoid arthritis. Most patients (87/125, 69.6%) had a paper file, 19.2% (24/125) used a digital tool (spreadsheets, 10/125, 8%; mobile app, 9/125, 7.2%; or website, 5/125, 4%), and 24.8% (31/125) did not use any tools for monitoring. Few patients (16/125, 12.8%) used tools for treatment reminders. About 21.6% (27/125) of the patients using eHealth used a specific app for rheumatoid arthritis. Univariate analysis showed that age, education level, employment status, treatment, comorbidities, membership of a patient association, and patient education program were associated with eHealth use for rheumatoid arthritis. Multivariate analysis showed that membership of a patient association (odds ratio [OR] 5.8, 95% CI 3.0-11.2), use of biologic disease-modifying antirheumatic drugs (OR 0.6, 95% CI 0.4-1.0), and comorbidities (OR 0.7, 95% CI 0.6-0.8) remained associated with eHealth use for rheumatoid arthritis. Recommendation by a doctor (225/330, 68.2%), ease of use (105/330, 31.8%), and data security (69/330, 20.9%) were factors favoring the use of eHealth. Conclusions To date, few patients have used eHealth for disease management. The use of a reliable and validated eHealth tool for rheumatoid arthritis could therefore be promoted by rheumatologists and could optimize therapeutic adherence.
BACKGROUND The use of eHealth tools (internet, mobile applications, connected devices) in chronic diseases and in the field of rheumatoid arthritis (RA) is growing. eHealth may improve the overall quality of care of patients suffering from chronic diseases. OBJECTIVE The main objective of this study was to describe the use of eHealth by patients with RA in France. The secondary objectives were to identify associations between demographic and disease characteristics and eHealth tools use and also to assess patients’ expectations for eHealth. METHODS We conducted a cross-sectional, multicenter study. Patients with RA according to the ACR / EULAR 2010 criteria were recruited in 5 University Hospitals (Bordeaux, Clermont-Ferrand, Limoges, Montpellier and Toulouse). Patients completed an anonymous self-questionnaire including demographic data, assessment of the use of eHealth (access, support, frequency of use, type of use, reason for use). The rheumatologist in charge of the patient completed an independent medical questionnaire collecting the disease characteristics, the activity of RA and the treatments. Data were collected from December 2018 to July 2019. RESULTS The questionnaires were completed by 575 patients, with an average age of 62±13 years, 78% of whom were women. 473 (82%) patients had access to eHealth through a computer (n=402 (86%)), a tablet (n=188 (40%)) or a smartphone (n=221 (47%)). Among them, 170 (37%) used internet for health in general and 134 (29%) specifically for RA. Regarding the use of eHealth for RA, all patients used it to learn about the pathology and 89 (66%) as a tool to help monitoring RA. Most of them (n=87, (70%)) had a paper file, 24/125 patients (19%) used a digital tool (spreadsheet n=10, 8% and/or mobile application n=9, 7% and/or website n=5, 4%) and 31 patients (25%) did not use a tool to monitor their RA. Few patients (12%) used numeric reminders of treatments. A specific application for RA was used by 27 patients (21%) using eHealth. Age, level of study, employment, treatment, comorbidities, membership of a patient association and patient education program were associated with the use of eHealth for RA in univariate analysis. In multivariate analysis, membership of patient association (OR: 5.8 [3.0-11.2]), bDMARDs use (OR: 0.6 [0.4-1]) and comorbidities (OR: 0.7 [0.6-0.8]) remained associated with eHealth use for RA. According to the patients, recommendation by a doctor (n=225, 68%), ease of use (n=105, 32%) and data security (n=69, 21%) were the factors that would favor the use of eHealth. CONCLUSIONS To date, few patients have used eHealth for their disease. The use of a reliable and validated eHealth tool in RA could therefore be promoted by rheumatologists and could optimize the therapeutic adherence. CLINICALTRIAL NCT03754855
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