There is very limited evidence for the effectiveness of IDIs on PA and HRQoL in RA and JIA and no evidence for their effectiveness in PsA or AS
The aim of this systematic review was to evaluate the evidence from r and omised controlled trials ( RCTs ) evaluating the effectiveness of interactive digital interventions ( IDIs ) for physical activity ( PA )  and  health related quality of life ( HRQoL )  in people with Inflammatory Arthritis [ rheumatoid arthritis ( RA ) , juvenile idiopathic arthritis ( JIA ) axial Spondyloarthritis ( AS ) and psoriatic arthritis ( PsA ) ] .
The Effect of Social Support Features and Gamification on a Web-Based Intervention for Rheumatoid Arthritis Patients: Randomized Controlled Trial
Background Rheumatoid arthritis ( RA ) is chronic systematic disease that affects people during the most productive period of their lives . Web-based health interventions have been effective in many studies ; however , there is little evidence and few studies showing the effectiveness of online social support and especially gamification on patients ’ behavioral and health outcomes . Objective The aim of this study was to look into the effects of a Web-based intervention that included online social support features and gamification on physical activity , health care utilization , medication overuse , empowerment , and RA knowledge of RA patients . The effect of gamification on website use was also investigated . Methods We conducted a 5-arm parallel r and omized controlled trial for RA patients in Ticino ( Italian-speaking part of Switzerl and ) . A total of 157 patients were recruited through brochures left with physicians and were r and omly allocated to 1 of 4 experimental conditions with different types of access to online social support and gamification features and a control group that had no access to the website . Data were collected at 3 time points through question naires at baseline , posttest 2 months later , and at follow-up after another 2 months . Primary outcomes were physical activity , health care utilization , and medication overuse ; secondary outcomes included empowerment and RA knowledge . All outcomes were self-reported . Intention-to-treat analysis was followed and multilevel linear mixed models were used to study the change of outcomes over time . Results The best-fit multilevel models ( growth curve models ) that described the change in the primary outcomes over the course of the intervention included time and empowerment as time-variant predictors . The growth curve analyses of experimental conditions were compared to the control group . Physical activity increased over time for patients having access to social support sections plus gaming ( unst and ardized beta coefficient [B]=3.39 , P=.02 ) . Health care utilization showed a significant decrease for patients accessing social support features ( B=–0.41 , P=.01 ) and patients accessing both social support features and gaming ( B=–0.33 , P=.03 ) . Patients who had access to either social support sections or the gaming experience of the website gained more empowerment ( B=2.59 , P=.03 ; B=2.29 , P=.05 ; respectively ) . Patients who were offered a gamified experience used the website more often than the ones without gaming ( t 91=–2.41 , P=.02 ; U=812 , P=.02 ) . Conclusions The Web-based intervention had a positive impact ( more desirable outcomes ) on intervention groups compared to the control group . Social support sections on the website decreased health care utilization and medication overuse and increased empowerment . Gamification alone or with social support  increased physical activity and empowerment and decreased health care utilization . This study provides evidence demonstrating the potential positive effect of gamification and online social support on health and behavioral outcomes . Trial Registration International St and ard R and omized Controlled Trial Number ( IS RCT N ) : 57366516 ; http://www.controlled-trials . com/IS RCT N57366516 ( Archived by webcite at http://www.webcitation.org/6PBvvAvvV )
There is very limited evidence for the effectiveness of IDIs on PA and HRQoL in RA and JIA and no evidence for their effectiveness in PsA or AS
The aim of this systematic review was to evaluate the evidence from r and omised controlled trials ( RCTs ) evaluating the effectiveness of interactive digital interventions ( IDIs ) for physical activity ( PA )  and  health related quality of life ( HRQoL )  in people with Inflammatory Arthritis [ rheumatoid arthritis ( RA ) , juvenile idiopathic arthritis ( JIA ) axial Spondyloarthritis ( AS ) and psoriatic arthritis ( PsA ) ] .