POS0182 SELF-MONITORING PRACTICES AND USE OF SELF-MONITORING TECHNOLOGIES IN PEOPLE WITH RHEUMATIC AND MUSCULOSKELETAL DISEASES: A WEB SURVEY STUDY
Authors: P. Studenic, P. Matias, S. Rêgo, F. Nunes, R. Araújo, N. Kartschmit, T. C. Wilhelmer
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Rheumatic and Musculoskeletal Diseases (RMDs) impact a population exceeding 120 million individuals within Europe and necessitate regular medical follow-up. The implementation of digital health applications (DHA) has been proposed to enhance management of these diseases. Nevertheless, the adherence of patients to these applications remains suboptimal in parallel to scarcity of research regarding self-monitoring practices of patients. <h3>Objectives:</h3> Our objectives were to examine the self-monitoring practices of RMD patients, associate with health-related quality of life (hrQoL) and technology usage to evaluate the potential for integrating DHAs into the care process. <h3>Methods:</h3> A web-based survey was carried out from July 2022 to March 2023, targeting Europeans with RMDs in order to examine their practices related to self-monitoring. Health status (EQ-5D-5L, Global Assessments (PGA-VAS)), sociodemographic factors, and indicators of adherence to technology were collected to facilitate comparison. Descriptive statistics were used to summarize. To explore the patterns of behavior exhibited by various patient profiles, group associations (Logistic Regression, MANOVA) and unsupervised profiling techniques (Uniform Manifold Approximation and Projection (UMAP) feature projection, k-means clustering) were employed. <h3>Results:</h3> The study included 228 RMD participants. Most participants were female (81%), half of them 40 to 60 years (&lt;40 years: 33.3%; &gt;60 years: 16.2%) of age, mostly from Austria and Portugal, with 35% RA, 18% SpA, 18% SLE and 14% PsA reported as diagnoses. Participants showed expectedly lower hrQoL by EQ5D index values (mean: 0.8±0.2) than general population norms, a mean PGA of 49±31mm, with 97% using smartphone and internet several times per week. Most respondents (52%) indicated non-digital and 23% digital means for symptom monitoring. Condition-related symptoms were tracked daily or few times per week (11%), weekly (12%) or monthly (13%), while 64% tracked once in 6 months or not at all. People tracking once a week or less reported that their condition was under control (20%) or had low disease activity (27%) as reasons for not tracking more frequently. Other reasons were no perceived value (15%), too much effort (13%) and not wanting to be reminded of their RMD (12%). Medication side effects (22%), new symptoms (22%), disease flares (20%) and medication dose reduction (9%) were reported as common situations to track. Digital technologies were positively perceived by the majority, for improving condition self-monitoring (75%), self-care (72%), patient-doctor communication (71%) and to lead to more personalized treatments (65%). Participants who regularly record their symptoms (at least monthly) were more positive about the potential benefits of mobile apps for monitoring (OR: 0.7 [0.5, 1.0], p=0.050), patient-physician communication (OR: 0.7 [0.5, 1.0], p=0.049), and symptom tracking (OR: 0.6 [0.38, 0.86], p=0.007). They used more devices (OR: 3.4 [1.5, 8.0], p=0.004), also monitoring symptoms through more diverse means (OR: 2.4 [1.3, 4.3], p=0.003) and in more specific situations (OR: 3.1 [2.2, 4.4], p&lt;0.001). Table 1 provides an overview of differences in health status depending on stable condition or monitoring regularity. Participants with regular monitoring practices had significantly worse scores on the EQ-VAS, PGA, EQ-5D-5L domains and EQ-index values compared to those who monitor irregularly. Participants in the regular monitoring group also had a wider range of medical specialists involved in their care. UMAP and clustering analyses identified three distinct clusters, with mainly in cluster 2 (71%) and 3 (84%) being characterized by stable condition or low disease activity as reasons for low symptom tracking (Figure 1). <h3>Conclusion:</h3> Effective use of DHAs for self-monitoring is still weak, usually due to low disease activity or no perceived value. Better patient engagement strategies should be adopted in early development stages of DHAs, helping increase adherence and encourage preventive care approaches for better long-term disease self-care. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> This work was supported by the project COTIDIANA (AAL2020-7-146-CP) funded under the AAL Joint Programme, by the European Commission and the National Funding Authorities of Portugal, Austria, and Switzerland. We would like to thank the outpatient team of the division of Rheumatology from the Vienna General Hospital, particularly Nasim Nakhost-Lotfi and Helga Radner for supporting survey engagement and advertisement, as well as to Ana Correia de Barros and Cristina Santos for the feedback given upon the question designing stage. Furthermore, we would like to highlight the role of the Portuguese League Against Rheumatic Diseases (LPDR) and the Austrian's Patient Association (ÖRL). <h3>Disclosure of Interests:</h3> Paul Studenic Speakers bureau: AstraZeneca, consultancy: AbbVie, Pedro Matias: None declared, Sílvia Rêgo: None declared, Francisco Nunes: None declared, Ricardo Araújo: None declared, Nadja Kartschmit: None declared, Tanita-Christina Wilhelmer: None declared.