Background Rheumatoid arthritis(RA) is a systemic chronic autoimmune disease that involves inflammatory arthritis with varying severity showing various symptoms like pain, fatigue, and sleep disturbances impacting and reducing the quality of life(QoL).[1] Patients with RA experience reduced QoL, physical and emotional health as well as level of independence etc and they are more likely to suffer from anxiety, depression and low self-esteem, with high levels of associated mortality and suicide.[3] Addressing the need to improve the quality of life and symptom burden for these patients are vital where Digital solutions play an incredibly significant role. These solutions are also helpful in self-management of disease and symptoms.

Objectives To assess the impact of a digital health program on the quality of life and symptom burden of patients suffering from Rheumatoid Arthritis.

Methods An interventional trial including an RA patient support program was delivered by Wellthy Care digital platform over a period of 16 weeks. Recruitment of 30 patients was done using a convenient sampling method. Patients who were diagnosed with RA were included in the trial. Patients who were under 18, pregnant/lactating, and with hearing disability were excluded. The program included interventions such as physiotherapy sessions, CBT (cognitive behavioural therapy) counselling, tracking of symptoms, lifestyle counselling, disease awareness and self-management training of symptoms at home. The rheumatoid arthritis impact of disease (RAID) [2] questionnaire, a validated questionnaire was administered to assess seven important patient domains of disease impact (pain, function, fatigue, sleep disturbance, emotional well-being, physical well-being, coping) at baseline and at the end of the program.

Results The Mean RAID score of the patients at baseline was 4.99 and at endline was 0.737. The impact percentage of program in improvement of symptoms like Pain, Difficulty in doing daily physical activities, Fatigue, Sleep difficulty, level of physical well-being, level of emotional well being were 85.66%, 86.40%, 88.81%, 96.47%, 85.66%, 93.89% respectively. The Paired T-test witnessed significant improvement in symptoms like pain, sleep disturbances, fatigue, difficulty in performing physical activities (p<0.001).

Conclusion Digital therapeutics play a highly significant role in improving the quality of life and reducing the symptom burden of RA patients. The digital patient support program led to meaningful changes in a patient’s quality of life as well as symptoms within a few weeks, even when the patient previously failed to experience a good prognosis during the treatment. Patients reported a highly significant improvement in Pain, Fatigue and Sleep disturbances, which improved the quality of life and patient’s outlook of the overall treatment and adherence. These digital solutions can be considered as holistic care and integrated with routine supportive care in practice to provide improved patient-centred care. RAID score functions well as a good patient reported outcome measure in routine health care for patients with RA.

References

1. Malm K, Bergman S, Andersson MLE, Bremander A, Larsson I. Quality of life in patients with established rheumatoid arthritis: A phenomenographic study. SAGE Open Med. 2017;5:2050312117713647. doi: 10.1177/2050312117713647, PMID 28611920
2. Catia Duarte etal Validity and reliability of the EULAR instrument RAID.7 as a tool to assess individual domains of impact of disease in rheumatoid arthritis: a cross-sectional study of 671 patients RMD Open. 2021;7(1):e001539.
3. Gettings L. Psychological well-being in rheumatoid arthritis: a review of the literature Lynda Gettings BSc (Hons), SRN. Musculoskeletal Care. March 15 2010;8(2):99-106. doi: 10.1002/msc.171, PMID 20232479.

Acknowledgements: NIL.

Disclosure of Interests None Declared.

Keywords: Patient reported outcomes, Quality of life, Rheumatoid arthritis

DOI: 10.1136/annrheumdis-2023-eular.157