ReMonit Gout
Self-management app for patients with gout.
Project Manager
PhD fellow
Postdoc
ABOUT THE PROJECT
Gout is an inflammatory rheumatic disease characterized by recurrent, very painful attacks. If you have an elevated uric acid level in the blood over time, uric acid crystals form, which can lead to acute inflammatory reactions in the joints. There is good drug treatment to lower uric acid levels. If patients receive the correct dosage of drug treatment, they can avoid having attacks if they continue to take the medication daily.
In today's treatment process, all patients who are about to start taking uric acid-lowering medications have a conversation with a nurse. The nurse provides information about gout, drug treatment and dietary advice. The patient is then followed up with monthly blood tests and telephone consultations with a nurse until the treatment goal is reached.
In the ReMonit Gout study, we will investigate whether the management app Urika can support patients starting uric acid-lowering treatment. The app was developed in collaboration with user representatives and clinicians, and was thoroughly tested by 21 patients in a usability study.
The app contains informational videos and text about the disease and treatment methods, reminders for medications and blood tests, and a graph with an overview of the patient's uric acid level and treatment goal. It also has a function for adjusting medication doses and a messaging service for nurses.
A nurse will provide remote follow-up via a digital platform linked to the app. We will test the digital follow-up in a clinical study (randomized, controlled, non-inferiority study), to investigate whether the follow-up is not inferior to the current telephone follow-up with a nurse.
WHO CAN JOIN?
Participants in the study will be recruited from adult patients referred to Diakonhjemmet Hospital, who are diagnosed with gout and are about to start uric acid-lowering treatment.
It is also a requirement that participants own a smartphone or tablet and have good knowledge of Norwegian.
WHAT DOES THE STUDY INVOLVE?
The study will last for 2 years. All patients will have an initial consultation with a nurse at Diakonhjemmet Hospital. Patients who agree to participate in the study will be randomly assigned (by drawing lots) to one of two groups:
- One group (the control group) will be followed up according to the current course of treatment with monthly telephone consultations with a nurse.
- The second group (the intervention group) will receive follow-up using the self-management app Urika and will be followed up digitally by a nurse.
All participants will have blood tests and answer a digital questionnaire at baseline, and after 1 and 2 years. In addition, everyone will be asked to answer a few questions every 3 months. Blood tests will be taken every month until the treatment goal is reached, and 3 months after the goal is reached. Everyone who participates in the study will be called in for a blood test and consultation with a nurse at the hospital after 1 year, after which the patients will be followed up by their GP with blood tests approximately every 6 months. After 2 years, the participants will again be called in for a blood test and consultation with a nurse.
After 1 and 2 years, we will evaluate whether digital follow-up is not inferior to nurse-led follow-up with telephone consultations in achieving the treatment goal. We will also conduct a health economic evaluation of the two follow-up strategies.