Spondyloarthritis is a severe, chronic, rheumatic joint disease that requires frequent and lifelong follow-up in specialist care. The aim of this three-arm randomized controlled trial is to investigate whether two new strategies for follow-up are as good as the current follow-up with regular physical attendance at the outpatient clinic in terms of maintaining low disease activity over time.
The lessons learned and results from this study have the potential to change how patients with spondyloarthritis are followed up by specialist services in the future.
Patients aged 18 years and older with a diagnosis of spondyloarthritis at Diakonhjemmet Hospital will be recruited if they meet the inclusion criteria, which include low disease activity and stable drug treatment during the last six months.
Recruitment of participants for the study has been completed.
Group 1 will receive follow-up as it is done today with questionnaires, blood tests and physical consultations at the hospital every 6 months. Participants in groups 2 and 3 will not be scheduled for fixed consultations, but they will be asked to download an app (MyDignio) where they can answer disease-related questions and upload pictures of blood test results. They will also be asked to wear an activity monitor (simple watch) that measures the number of daily steps and the number of minutes of medium and high intensity physical activity. About 15 of the participants will also test out measuring C-reactive protein (CRP) from home. Participants can also send messages to health professionals through the app.
For group 2, healthcare professionals will monitor questionnaire responses and activity data in order to detect any significant deterioration of the disease. Healthcare professionals can then contact patients by phone or send a message in the Dignio application to assess the need for a hospital visit or video consultation.
Participants in group 3 will not be scheduled for regular consultations, but, like groups 1 and 2, will be instructed to contact a health professional at the hospital if they experience a significant worsening of symptoms and believe they should be assessed by a health professional.
In addition to self-reported data on symptoms and function, patients will report adverse events, coping, quality of life, health service use, work participation and physical activity levels. We will also collect data from four national registries on health service utilization, medication use and sickness absence as well as blood test results recorded in the patient record.