A Novel Mobile App & Population Management System to Manage Rheumatoid Arthritis Flares

Although most rheumatoid arthritis (RA) patients experience at least one flare over a six-month period, the majority of these flares are not reported to health care providers (HCPs). This disconnect between patient experience and HCP awareness impairs effective disease management. The goal of this study is to implement a smartphone application (app) + population management system to monitor RA disease activity between scheduled HCP visits. We plan to accomplish this objective by pursuing two specific aims: 1) to determine the impact of the smartphone app + population management system on patient satisfaction with treatment and perception of the patient-HCP interaction, and 2) to assess the effect of the smartphone app + population management system on RA disease activity. The proposed project will be a randomized controlled trial, with participants randomized to the smartphone app + population management system vs. a waitlist control. The target audience includes 190 RA patients with moderate-severe disease activity who are taking disease-modifying antirheumatic drugs. The primary outcomes will be scores on the Treatment Satisfaction Questionnaire for Medication, the Patient-Physician Interactions Questionnaire, and the Clinical Disease Activity Index at six months. The evaluation of treatment effects (mean differences in outcomes between groups at six months) will be estimated with mixed models. The results are expected to have an important positive impact by enabling patients to document self-reported disease activity on a real-time basis, securely transferring data to HCP offices via a web-based dashboard, and consolidating and communicating concerning trends to HCPs via a population manager.