The use of disease-modifying drugs has revolutionized the treatment of people with rheumatoid arthritis, resulting in a positive change in prognosis for these patients. The goal of treatment is remission (absence of symptoms), but although some patients remain in remission over time, it is common for disease activity to fluctuate and a large proportion of patients experience disease worsening (flare-ups or treatment failure). Patients are therefore followed up with frequent check-ups. However, these checks 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 a consultation to assess changes in treatment and which patients are well treated and do not need to come for a consultation. This algorithm will now be tested in a randomized controlled non-inferiority trial where we want to investigate whether digital home follow-up is not inferior to regular follow-up (hospital consultations) when it comes to maintaining good disease control.
If digital home monitoring is not inferior to regular monitoring, it would be appropriate to introduce this as part of clinical practice for relevant patients with rheumatoid arthritis.
Patients 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.
Recruitment of participants will start in September 2022.
Patients will complete patient-reported data before being randomly assigned to one of two groups: One group (the control group) will be followed up according to current routines with in-hospital consultations following a standardized schedule. The other group (the intervention group) will be followed up remotely through monthly patient reporting from home through the web app Youwell. Patients in this group will be called in for a check-up if the patient reporting indicates a worsening of the disease state.
After 2 years, it will be evaluated whether both groups have equally good disease control, as measured by radiographic changes, disease activity and function.