Rheumatoid arthritis is a chronic, inflammatory joint disease affecting around 1% of the UK population. Modern targeted approaches to treating rheumatoid arthritis involve frequent monitoring of the disease focusing on ‘flares’, with the goal of making the disease go into remission or reducing the impact of the disease.
In the UK and US, innovative ways of monitoring rheumatoid arthritis have been implemented using smartphone apps drawing on Patient Reported Outcome Measures (PROMs). These PROMs assess the quality of care delivered to patients from the patient perspective. The aim of this digital technology is to help identify patients who need to be seen by a specialist (eg because they are experiencing a ‘flare’) so that treatment can be delivered in a timely way.
In partnership with the Health Innovation Network South London and Guy’s and St Thomas’ NHS Foundation Trust (GSTT), KIS is evaluating a new remote monitoring service for patients with rheumatoid arthritis. This service was developed and piloted at GSTT, before being rolled out to five additional hospitals. Additional key collaborators in the evaluation include patient members and the National Rheumatoid Arthritis Society (NRAS).
Project aim:
To evaluate a scaled-up, two-way remote monitoring service, capturing monthly Rheumatoid Arthritis Impact of Disease scores and patient-generated text messages, for patients with rheumatoid arthritis attending routine outpatient clinics across six hospitals at three NHS Trusts in south-east London. Specifically, we explored patient and staff experiences and implementation outcomes, including acceptability, and barriers and drivers to implementation.
Key objectives:
A pragmatic, mixed methods approach was used to explore multiple data sources. This included:
- A rapid evidence synthesis review of remote monitoring in rheumatoid arthritis.
- Analysis of routinely collected service-level data, extracted from the remote monitoring platform.
- An online patient survey.
- Semi-structured interviews with patients and staff, informed by the Capability, Opportunity, Motivation, Behaviour (COM-B) and Exploration, Preparation, Implementation, Sustainment (EPIS) theoretical frameworks, respectively.
Research outputs and events:
- A visual abstract outlining the study design, patient involvement and key results
- Blog by lived experience team members
- Blog: The key to evaluation: involving experts by experience in our research on remote monitoring (Health Innovation Network)
- Watch a recording of an online panel and Q&A event in collaboration with the National Rheumatoid Arthritis Society held on 28 June 2023
- Read the paper: Remote monitoring of patients with rheumatoid arthritis in a low disease activity state: a mixed methods evaluation across six hospitals in London, UK, Rheumatology (Feb 2024)
- A poster: Remote monitoring of patients with rheumatoid arthritis: a mixed methods evaluation across six hospitals in London, UK
- Read an article in the National Rheumatoid Arthritis Society (NRAS) Members Magazine (Autumn 2023)
