Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Brigham and Women's Hospital, Boston, Massachusetts.
Arthritis Rheumatol. 2021 Aug;73(8):1421-1429. doi: 10.1002/art.41686. Epub 2021 Jun 18.
To examine the effects of a smartphone application (app) to monitor longitudinal electronic patient-reported outcomes (ePROs) on patient satisfaction and disease activity in patients with rheumatoid arthritis (RA).
We conducted a 6-month randomized controlled trial of care coordination along with an app (intervention) versus care coordination alone (control) in 191 RA patients. Participants in the intervention group were prompted to provide information daily using ePROs. In both the intervention and control groups, a care coordinator contacted participants at 6 and 18 weeks to assess for flares. The main outcome measures were the global satisfaction score from the Treatment Satisfaction Questionnaire for Medication (TSQM), the score from the Perceived Efficacy in Patient-Physician Interactions (PEPPI) Questionnaire, and the Clinical Disease Activity Index (CDAI) score.
Groups were similar at baseline. The median TSQM score at 6 months was 83.3 in both groups, and the median PEPPI score at 6 months was 50 in both groups. The median CDAI score at 6 months was 8 in the intervention group versus 10 in the control group. No statistically significant group differences in the medians of TSQM, PEPPI, or CDAI scores at 6 months were detected. Of the 67 intervention participants who completed the exit survey, 90% rated their likelihood of recommending the app as ≥7 of 10. Of the 11 physicians who completed the exit survey, 73% agreed/strongly agreed that they wanted to continue offering the app to patients.
A mobile app designed to collect ePRO data on RA symptoms did not significantly improve patient satisfaction or disease activity compared to care coordination alone. However, both patients and physicians reported positive experiences with the app.
研究一款用于监测纵向电子患者报告结局(ePROs)的智能手机应用程序(app)对类风湿关节炎(RA)患者的满意度和疾病活动度的影响。
我们对 191 名 RA 患者进行了为期 6 个月的随机对照试验,比较了在常规护理基础上加用 app(干预组)与仅接受常规护理(对照组)的效果。干预组患者每日需通过 ePRO 提供信息。在干预组和对照组中,护理协调员均会在第 6 周和第 18 周联系患者,以评估是否出现病情恶化。主要结局指标为药物治疗满意度问卷(TSQM)的总体满意度评分、医患互动感知效能问卷(PEPPI)评分和临床疾病活动指数(CDAI)评分。
两组患者在基线时相似。两组患者的 TSQM 评分中位数在 6 个月时均为 83.3,PEPPI 评分中位数在 6 个月时均为 50。干预组患者的 CDAI 评分中位数在 6 个月时为 8,对照组患者的 CDAI 评分中位数在 6 个月时为 10。两组患者在 6 个月时的 TSQM、PEPPI 和 CDAI 评分中位数无统计学差异。在完成退出调查的 67 名干预组患者中,90%的患者将推荐该 app 的可能性评为 10 分制的≥7 分。在完成退出调查的 11 名医生中,73%的医生表示同意/强烈同意希望继续向患者提供该 app。
与常规护理相比,用于收集 RA 症状的 ePRO 数据的移动 app 并未显著改善患者的满意度或疾病活动度。然而,患者和医生均报告了对该 app 的积极体验。