AB0281 UTILIZATION OF SMART PHONE APPLICATION TO ASSESS THE DISEASE OUTCOMES IN RHEUMATOID ARTHRITIS: SMART- RA STUDY
Authors: Ashit Syngle, Nidhi Garg, Reeve Rana, Shivani Sherawat
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Rheumatoid arthritis (RA) is a chronic inflammatory disorder which if not managed properly leads to joint destruction, disability, poor quality of life and premature mortality. Disease modifying antirheumatic drugs (DMARDs) have considerably improved disease outcome in RA. However, poor patient compliance significantly limits the benefits that could be accrued from DMARDs. In a technology driven era, with more people having access to smart phones, unique opportunities exist for use of phone-based technologies to improve patient care in chronic diseases. This study aims to investigate whether the use of HealthCius smart phone application for self management can influence quality of life for patients with RA and improve inflammatory disease activity. <h3>Objectives</h3> To investigate the impact of smart phone application (HealthCius) on inflammatory disease activity and quality of life in RA. <h3>Methods</h3> 38 RA patients fulfilling the 2010 Rheumatoid Arthritis Classification Criteria were recruited. Subjects were randomized into 2 groups. First, having access to a smart phone were assigned to the intervention group using the Healthcius application (n=23) and second, the control group not using the application (n=15). The patients in two groups received standard treatment of RA. The application was designed after obtaining feedback from health care providers, patient counselors and RA patients using a questionnaire. To the patients, the app was their individual treatment plan. It helped them comply with the plan by providing an easy to refer checklist, reminders, alerts and a visual dashboard of their progress through the day. The app served as the doctor's virtual assistant inside the patient's smart phone. For the doctor, it was a live dashboard of all patients and their real time compliance levels. The data reported by the patients was available to the doctor in the form of time sliced charts and trend lines. Therefore, this app is designed to leverage technology to shift the patients' focus every day on to their treatment plan thereby driving up compliance and better health outcomes. Outcome measures included erythrocyte sedimentation rate (ESR), C-Reactive protein (CRP), disease activity score (DAS28) and health assessment questionnaire (HAQ-DI) at baseline and at 12 weeks. <h3>Results</h3> Baseline characteristics were similar between groups with no significant difference. There was a significant difference between the control and intervention group for DAS28 (p &lt;0.05), ESR (p≤0.05), CRP (p≤0.05) and HAQ-DI (p≤0.5) after 12 weeks in favor of smart phone application. Analysis within the groups revealed significant improvement in DAS28 (p&lt;0.05) (Fig.1A), ESR (p=0.01) (Fig.1B), CRP (p=0.001) (Fig.1C) and HAQ-DI (p=0.01) (Fig.1D) in the application group as compared to control group. Impact of DMARDs usage was also evaluated at the end of the study and it was found that the average drug usage of DMARDs was more in control group than the intervention group. <h3>Conclusion</h3> The study suggested that there was greater improvement in inflammatory disease activity and quality of life in smart phone application assisted RA patients suggesting that smart phone technology can be used to leverage health benefits in RA. <h3>Reference</h3> [1] Azevedo R, Bernardes M, Fonseca J, Lima A. Smartphone application for rheumatoid arthritis self-management: cross-sectional study revealed the usefulness, willingness to use and patients' needs. Rheumatol Int. 2015Oct; 35(10):1675-85. doi: 10.1007/s00296-015-3270-9. Epub 2015 Apr 24. <h3>Acknowledgement</h3> None <h3>Disclosure of Interests</h3> None declared