Harnessing interactive technologies to improve health outcomes in juvenile idiopathic arthritis

Abstract

Background: Children and adolescents with Juvenile Idiopathic Arthritis (JIA) typically have reduced physical activity level and impaired aerobic and anaerobic exercise capacity when compared to their non-JIA counterparts. Low intensity exercise regimens appear to be safe in children with JIA and may results in improvements in overall physical function. Poor adherence to paediatric rheumatology treatment may lead to negative clinical outcomes and possibly increased disease activity. This includes symptoms such as pain, fatigue, quality of life, longer term outcomes including joint damage, as well as increase of healthcare associated costs. Low adherence to medications such as methotrexate and biological-drugs remains a significant issue for paediatric rheumatologists, with alarming reports that less than half of the children with JIA are compliant to drug-therapy. Main body: The recent advances in interactive technology resulting in a variety of wearable user-friendly smart devices may become a key solution to address important questions in JIA clinical management. Fully understanding the impact that arthritis and treatment complications have upon individual children and their families has long been a challenge for clinicians. Modern interactive technologies can be customised and accessed directly in the hands or wrists of children with JIA. These secured networks could be accessible 'live' at anytime and anywhere by the child, parents and clinicians. Multidisciplinary teams in paediatric rheumatology may benefit from adopting these technologies to better understand domains such as patient biological parameters, symptoms progression, adherence to drug-therapy, quality of life, and participation in physical activities. Most importantly the use of smart devices technologies may also facilitate more timely clinical decisions, improve self-management and parents awareness in the progression of their child's disease. Paediatric rheumatology research could also benefit from the use of these smart devices, as they would allow real-time access to meaningful data to thoroughly understand the disease-patterns of JIA, such as pain and physical activity outcomes. Data collection that typically occurs once every 1 or 3 months in the clinical setting could instead be gathered every week, day, minute or virtually live online. Arguably, few limitations in wearing such interactive technologies still exist and require further developments. Conclusion: Finally, by embracing and adapting these new and now highly accessible interactive technologies, clinical management and research in paediatric rheumatology may be greatly advanced.

Comparison of a Mobile Health Electronic Visual Analog Scale App With a Traditional Paper Visual Analog Scale for Pain Evaluation: Cross-Sectional Observational Study

“…This study further adds to the growing body of evidence that supports the use of digital technologies in health care. eHealth and mHealth have already been extensively used as tools for education, diagnosis, and management of pathologies such as diabetes [ 35 , 36 ], pediatric rheumatology [ 37 ], polycystic ovarian syndrome [ 38 ], and alcoholism [ 39 ]. At present, there are limited approaches available that combine evidence-based practice with health apps [ 40 ].…”

Feasibility and safety of a 6-month exercise program to increase bone and muscle strength in children with juvenile idiopathic arthritis

“…Fitbits), social media (e.g. Strava) or internet-based interventions to monitor and encourage adherence, particularly when participants are not in close geographic proximity [ 42 – 44 ]. Armbrust and colleagues recently reported promising results for their internet-based PA intervention, “Rheumates @ Work” (R@W) [ 45 ].…”

Self-management needs of Irish adolescents with Juvenile Idiopathic Arthritis (JIA): how can a Canadian web-based programme meet these needs?

“…Discrepancies in the availability and quality of arthritis information demonstrate the need for a concise source of information on JIA self-management [ 20 , 24 ]. While general information is available on developing self-management skills, there is scope for providing easily-accessible, accurate information on JIA to Irish families.…”

“…Additional barriers for effective self-management are perceived within the Irish health-care context, and raised by the participants of this study: long wait-times for appointments, inconsistent access to services outside of urban areas, and limited availability of child and adolescent rheumatology professionals; the latter becoming common across Europe, with many countries failing to supply satisfactory training in adolescent health and medicine [ 22 , 23 ]. Accessible interventions to assist adolescents with self-management strategies can reduce these barriers [ 24 – 28 ].…”