Outcomes of a Mobile App to Monitor Patient‐Reported Outcomes in Rheumatoid Arthritis: A Randomized Controlled Trial

Abstract

Objective. To examine the effects of a smartphone application (app) to monitor longitudinal electronic patientreported outcomes (ePROs) on patient satisfaction and disease activity in patients with rheumatoid arthritis (RA).Methods. We conducted a 6-month randomized controlled trial of care coordination along with an app (intervention) versus care coordination alone (control) in 191 RA patients. Participants in the intervention group were prompted to provide information daily using ePROs. In both the intervention and control groups, a care coordinator contacted participants at 6 and 18 weeks to assess for flares. The main outcome measures were the global satisfaction score from the Treatment Satisfaction Questionnaire for Medication (TSQM), the score from the Perceived Efficacy in Patient-Physician Interactions (PEPPI) Questionnaire, and the Clinical Disease Activity Index (CDAI) score.Results. Groups were similar at baseline. The median TSQM score at 6 months was 83.3 in both groups, and the median PEPPI score at 6 months was 50 in both groups. The median CDAI score at 6 months was 8 in the intervention group versus 10 in the control group. No statistically significant group differences in the medians of TSQM, PEPPI, or CDAI scores at 6 months were detected. Of the 67 intervention participants who completed the exit survey, 90% rated their likelihood of recommending the app as ≥7 of 10. Of the 11 physicians who completed the exit survey, 73% agreed/strongly agreed that they wanted to continue offering the app to patients. Conclusion.A mobile app designed to collect ePRO data on RA symptoms did not significantly improve patient satisfaction or disease activity compared to care coordination alone. However, both patients and physicians reported positive experiences with the app.ClinicalTrials.gov identifier: NCT02822521.

Smartphone‐Assisted Patient‐Initiated Care Versus Usual Care in Patients With Rheumatoid Arthritis and Low Disease Activity: A Randomized Controlled Trial

“…While health care utilization dropped, no difference was found in patient-physician interaction, health care satisfaction, self-efficacy, or treatment satisfaction between the intervention and control groups. The lack of improvement following an intervention using a smartphone app in these outcomes was also found by Lee et al (14) but contrasts with other studies (15,17,34). In our study, the secondary outcome measures were already at favorable levels at baseline, which suggests that patients with low disease activity value the current system of face-to-face consultations, which has been previously described (35).…”

Nationwide, large-scale implementation of an online system for remote entry of patient-reported outcomes in rheumatology: characteristics of users and non-users and time to first entry

“…15 Importantly, not all patients have access, skills or interest in using remote digital solutions. 16 Although previous studies (mainly explorative or outside rheumatology) have demonstrated feasibility of electronic systems for online data entry of PROs, [17][18][19][20][21][22][23][24] no studies have to our knowledge explored use following large-scale routine care implementation of a nationwide online system in IRD.…”

Who stop telemonitoring disease activity and who adhere: a prospective cohort study of patients with inflammatory arthritis

“…Although high adherence to reporting ePRO’s through mobile applications (apps) was observed in recently performed trials that investigated telemonitoring, often adherence declined over time reducing the potential benefits [ 7 – 9 ]. For example, adherence decreased from 88 to 62% during the 6 month study of Lee et al [ 10 ]. In addition, Seppen et al reported declining adherence rates from > 90% in week one, to less than 50% in week four [ 11 ].…”