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NOR-Flare

Remote follow-up of patients with rheumatoid arthritis

Project manager
Physiotherapist | PhD

Professor Anne Therese Tveter, Deputy Head of REMEDY

Postdoc
Physiotherapist | PhD

Tuva Moseng

ABOUT THE PROJECT

The use of disease-modifying drugs has revolutionized the treatment of people with rheumatoid arthritis, which has resulted in a positive change in the prognosis for these patients. The goal of treatment is remission (absence of symptoms), but even though some patients are in remission over time, it is common for disease activity to fluctuate and a large proportion of patients experience disease exacerbation (flare-ups or treatment failure). Patients are therefore followed up with frequent check-ups. However, these check-ups follow a standardized schedule and thus do not necessarily coincide with periods of high disease activity. There is therefore a need for more personalized follow-up of people with inflammatory rheumatic disease.

Based on previously collected patient-reported data at Diakonhjemmet Hospital and artificial intelligence, this project has developed an algorithm that will identify which patients need to come for consultation for assessment of change in treatment and which patients are well treated and do not need to come for consultation. This algorithm will now be tested in a randomized controlled non-inferiority study where we want to investigate whether digital home follow-up is not inferior to regular follow-up (consultations at the hospital) when it comes to maintaining good disease control (structural, functional and clinical outcomes).

WHO CAN JOIN?

Patients treated at Diakonhjemmet Hospital and diagnosed with rheumatoid arthritis, considered to have low disease activity and stable medication use by the treating physician, with less than two swollen joints and not otherwise considered unsuitable for remote follow-up, will be asked to participate.

Inclusion ends when a total of 260 participants have been recruited.

WHAT DOES THE STUDY INVOLVE?

Participants will be randomly assigned to one of two groups. The control group will follow standard follow-up with a consultation at the hospital every 6 months. The intervention group will be followed with digital remote follow-up. Participants in this group will answer monthly questionnaires through the remote follow-up platform Youwell. Based on the answers, the patients will be triaged as to whether they should be contacted or not.

Participants will complete a questionnaire every 6 months and will, as usual, be asked to take blood tests every 3 months to detect any side effects of the medications. Participants in the study will be followed up for 2 years.
 
Participants will not be paid to participate in the study and will pay a co-payment for any consultations in line with standard clinical practice.
 
If digital home follow-up is not inferior to regular follow-up, it would be appropriate to introduce this as part of clinical practice for relevant patients with rheumatoid arthritis.
 
Participants in the control group will follow the same follow-up as is currently provided and there will therefore be no immediate benefits from participating in the study. Nevertheless, participation will provide us with important knowledge about new digital follow-up strategies.
 
For participants in the intervention group, there may be fewer consultations at the hospital than usual. This may save time and travel costs and possibly less absence from work. You will be asked to answer questions about any complaints a little more often than usual.
 
All participants can contact and receive a consultation at the hospital if they experience a flare-up of the disease.