Attitudes to technology-supported rheumatoid arthritis care, questionnaire study: opportunities for technology to improve ra care

Abstract Background/Aims Rheumatoid arthritis (RA) outcomes have significantly improved with the treat-to-target paradigm, however this necessitates intensive monitoring. Demand outstrips capacity in rheumatology services, making Mobile Health (mHealth) an attractive prospect. However, software developers often design without understanding the needs of ultimate users, solving non-existent problems. EULAR’s ‘Points to Consider’ for remote care specifies that interventions “should be developed in collaboration with all stakeholders including the healthcare team … and people with RMDs” as an overarching principle. This study sought to understand existing challenges for end-users, and how technology might support these. Methods Questionnaires were devised collaboratively between Rheumatologists and Computer scientists, informed by discussions with an RA patient group. People >18 years old with a diagnosis of RA completed paper surveys (utilising likert scales, ranking preferences, and tick-box answers) whilst awaiting appointments at Mile End Hospital (Barts Health NHS Trust). Clinicians were recruited to complete an online survey via mailing lists from multiple centres across London & South-East England, from October 2019-March 2020. The study was registered (CMPS ID [43816]). Ethical approval was obtained through the Bloomsbury Research and Ethics Committee (19/LO/1345). This work forms part of a larger mixed-methods study funded by the PAMBAYESIAN project grant (EP/P009964/1). Results 109 people with RA returned paper questionnaires, 41 clinicians completed the online survey. Pain management, flares, and medications were identified as key challenges by both groups, however patients ranked lifestyle changes much higher than clinicians, who considered disease acceptance and understanding more significant. Considering opportunities; people with RA rated accessing their rheumatologist as the most useful potential feature (72.9%), followed by joint count body maps (59.8%), setting the agenda for appointments (52.3%), information about RA (45.8%) and support with drug monitoring (45.8%). Clinicians rated medication support most useful(96.8%), followed by information about RA (87.1%), agenda setting (87.1%) and flare management (83.9%). Conclusion People with RA and their clinicians identify flares, pain, and medication management as key challenges in the disease, although clinicians may underestimate the impact upon patients’ lifestyles. Medication support, information giving, and agenda setting for appointments. Disclosure A. MacBrayne: None. H. Soyel: None. W. Marsh: None. N. Fenton: None. C. Pitzalis: None. P. Curzon: None. F. Humby: None.