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一种用于管理类风湿性关节炎发作的新型移动应用程序和人群管理系统:一项随机对照试验的方案

A Novel Mobile App and Population Management System to Manage Rheumatoid Arthritis Flares: Protocol for a Randomized Controlled Trial.

作者信息

Wang Penny, Luo Dee, Lu Fengxin, Elias Josephine S, Landman Adam B, Michaud Kaleb D, Lee Yvonne C

机构信息

Division of Rheumatology, Immunology and Allergy, Department of Medicine, Brigham and Women's Hospital, Boston, MA, United States.

Digital Health Innovation Group, Brigham and Women's Hospital, Boston, MA, United States.

出版信息

JMIR Res Protoc. 2018 Apr 11;7(4):e84. doi: 10.2196/resprot.8771.

Abstract

BACKGROUND

Rheumatoid arthritis flares have a profound effect on patients, causing pain and disability. However, flares often occur between regularly scheduled health care provider visits and are, therefore, difficult to monitor and manage. We sought to develop a mobile phone app combined with a population management system to help track RA flares between visits.

OBJECTIVE

The objective of this study is to implement the mobile app plus the population management system to monitor rheumatoid arthritis disease activity between scheduled health care provider visits over a period of 6 months.

METHODS

This is a randomized controlled trial that lasts for 6 months for each participant. We aim to recruit 190 patients, randomized 50:50 to the intervention group versus the control group. The intervention group will be assigned the mobile app and be prompted to answer daily questionnaires sent to their mobile devices. Both groups will be assigned a population manager, who will communicate with the participants via telephone at 6 weeks and 18 weeks. The population manager will also communicate with the participants in the intervention group if their responses indicate a sustained increase in rheumatoid arthritis disease activity. To assess patient satisfaction, the primary outcomes will be scores on the Treatment Satisfaction Questionnaire for Medication as well as the Perceived Efficacy in Patient-Physician Interactions questionnaire at 6 months. To determine the effect of the mobile app on rheumatoid arthritis disease activity, the primary outcome will be the Clinical Disease Activity Index at 6 months.

RESULTS

The trial started in November 2016, and an estimated 2.5 years will be necessary to complete the study. Study results are expected to be published by the end of 2019.

CONCLUSIONS

The completion of this study will provide important data regarding the following: (1) the assessment of validated outcome measures to assess rheumatoid arthritis disease activity with a mobile app between routinely scheduled health care provider visits, (2) patient engagement in monitoring their condition, and (3) communication between patients and health care providers through the population management system.

TRIAL REGISTRATION

ClinicalTrials.gov NCT02822521, http://clinicaltrials.gov/ct2/show/NCT02822521 (Archived by WebCite at http://www.webcitation.org/6xed3kGPd).

摘要

背景

类风湿关节炎病情发作会对患者产生深远影响,导致疼痛和残疾。然而,病情发作常发生在定期预约的医疗服务提供者就诊之间,因此难以监测和管理。我们试图开发一款结合人群管理系统的手机应用程序,以帮助追踪就诊期间的类风湿关节炎病情发作情况。

目的

本研究的目的是应用该移动应用程序加人群管理系统,在6个月的时间内监测定期预约的医疗服务提供者就诊期间的类风湿关节炎疾病活动情况。

方法

这是一项随机对照试验,每位参与者持续6个月。我们计划招募190名患者,以50:50的比例随机分为干预组和对照组。干预组将被分配使用该移动应用程序,并被要求回答发送到其移动设备上的每日问卷。两组都将分配一名人群管理员,该管理员将在6周和18周时通过电话与参与者沟通。如果干预组参与者的回答表明类风湿关节炎疾病活动持续增加,人群管理员也将与他们沟通。为了评估患者满意度,主要结局指标将是6个月时的药物治疗满意度问卷得分以及医患互动中感知疗效问卷得分。为了确定移动应用程序对类风湿关节炎疾病活动的影响,主要结局指标将是6个月时的临床疾病活动指数。

结果

该试验于2016年11月开始,预计需要约2.5年完成研究。研究结果预计在2019年底公布。

结论

本研究的完成将提供有关以下方面的重要数据:(1)在常规预约的医疗服务提供者就诊期间,使用移动应用程序评估类风湿关节炎疾病活动的有效结局指标;(2)患者参与病情监测的情况;(3)通过人群管理系统实现患者与医疗服务提供者之间的沟通。

试验注册

ClinicalTrials.gov NCT02822521,http://clinicaltrials.gov/ct2/show/NCT02822521(由WebCite存档于http://www.webcitation.org/6xed3kGPd)

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b1b/5917083/b94c7f349356/resprot_v7i4e84_fig1.jpg

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