Patient-initiated care supported with smartphone self-monitoring is noninferior to usual care for rheumatoid arthritis (RA) in patients with stable low disease activity, according to a study published online July 11 in Arthritis & Rheumatology.
Bart Seppen, M.D., from Reade Rheumatology in Amsterdam, and colleagues assessed the safety and efficacy of a smartphone app for patients with RA, which allows them to self-monitor their disease activity in between clinic visits. The analysis included 102 patients randomly assigned to either app-supported patient-initiated care with a scheduled follow-up consultation after a year (app group) or usual care.
The researchers found that after a year, noninferiority of the disease activity score 28 (DAS-28) was established with the mean ΔDAS-28 between the groups within the noninferiority limit: −0.04 in favor of the app group (95 percent confidence interval, −0.39 to 0.30). In the app group, the number of rheumatologist consultations was significantly lower (visit ratio: 0.62; 95 percent confidence interval, 0.47 to 0.81).
“Our results show that [it] is possible to optimize RA health care delivery by letting patients initiate consultations and self-monitor their disease,” the authors write. “Our intervention strategy may reduce the workforce that is needed per RA patient and could therefore decrease health care costs per patient, which will be evaluated in a separate analysis.”