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NOR Flare

Distance follow-up of patients with rheumatoid arthritis

Project Manager
Physiotherapist | PhD

Professor Anne Therese Tveter, vice director of REMEDY

Post doc
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 prognosis for these patients. The treatment goal is remission (absence of symptoms), but even if some patients are in remission over time, it is common for disease activity to fluctuate and a large proportion of patients experience disease worsening (flare-up or treatment failure). The patients are therefore followed up with frequent checks. However, these checks follow a standardized timetable and thus do not necessarily occur at the same time as 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 capture which patients need to come to a consultation for assessment of a change in treatment and which patients are well treated and do not need to come to a 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 no worse than usual 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, assessed to have low disease activity and stable drug use by the attending physician, with less than two swollen joints and not otherwise considered unsuitable for distance follow-up, will be asked to participate.

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

WHAT DOES THE STUDY INCLUDE?

Participants are randomly drawn into 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 monitored with digital distance monitoring. The participants in this group will answer monthly questionnaires through the distance tracking platform Youwell. Based on the answers, the patients will be triaged as to whether they should be contacted or not.

Participants will answer 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 medication. Participants in the study will be followed up for 2 years.
 
Participants are not paid for taking part in the study and will pay a deductible for any consultations corresponding to normal clinical practice.
 
If digital home follow-up is no worse than usual follow-up, it will be relevant 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 that is given as of today and there will thus be no immediate benefits from taking part in the study. Nevertheless, participation will give us 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 can save time and costs for travel and possibly less absence from work. You will be asked to answer questions about any ailments a little more often than usual.
 
All participants can contact and get a consultation at the hospital should they experience a flare-up of the disease.