Benavent D, Fernández-Luque L, Sanz-Jardón M, Bilionis I, Novella-Navarro M, Navarro-Compán V, González-Sanz P L, Calvo E, Lojo L, Balsa A, Plasencia-Rodríguez Ch
Department of Rheumatology, Hospital Universitario La Paz, IdiPaz, Madrid, Spain.
AdheraHealth Inc., Santa Cruz, CA, USA.
BMC Rheumatol. 2023 Sep 25;7(1):32. doi: 10.1186/s41927-023-00362-7.
Rheumatic and musculoskeletal diseases (RMDs) require a tailored follow-up that can be enhanced by the implementation of innovative tools. The Digireuma study aimed to test the feasibility of a hybrid follow-up utilizing an electronic patient reported outcomes (ePROs)-based monitoring strategy in patients with RMDs.
Adult patients with rheumatoid arthritis (RA) and spondyloarthritis (SpA) were recruited for a 6-month bicentric prospective follow-up consisting of face-to-face and digital assessments. Patients were asked to report disease-specific ePROs on a pre-established basis, and could also report flares, medication changes, and recent infections at any time. Four rheumatologists monitored these outcomes and contacted patients for interventions when deemed necessary. Results from face-to-face and digital assessments were described.
Of 56 recruited patients, 47 (84%) submitted any ePROs to the digital platform. Most patients with RA were female (74%, median age of 47 years), while 48% of patients with SpA were female (median age 40.4 years). A total of 3,800 platform visits were completed, with a median of 57 and 29 visits in patients with RA and SpA, respectively. Among 52 reported alerts, 47 (90%) needed contact, of which 36 (77%) were managed remotely. Adherence rates declined throughout the study, with around half of patients dropping out during the 6 months follow-up.
The implementation of a hybrid follow-up in clinical practice is feasible. Digital health solutions can provide granular knowledge of disease evolution and enable more informed clinical decision making, leading to improved patient outcomes. Further research is needed to identify target patient populations and engagement strategies.
风湿性和肌肉骨骼疾病（RMD）需要量身定制的随访，而创新工具的应用可加强随访。Digireuma研究旨在测试在RMD患者中采用基于电子患者报告结局（ePROs）的监测策略进行混合随访的可行性。
招募成年类风湿关节炎（RA）和脊柱关节炎（SpA）患者进行为期6个月的双中心前瞻性随访，包括面对面和数字化评估。要求患者在预先设定的基础上报告特定疾病的ePROs，也可随时报告病情复发、药物变化和近期感染情况。四名风湿病专家监测这些结果，并在必要时联系患者进行干预。描述了面对面和数字化评估的结果。
在56名招募的患者中，47名（84%）向数字平台提交了任何ePROs。大多数RA患者为女性（74%，中位年龄47岁），而SpA患者中48%为女性（中位年龄40.4岁）。共完成3800次平台访问，RA患者和SpA患者的访问中位数分别为57次和29次。在52次报告的警报中，47次（90%）需要联系，其中36次（77%）通过远程处理。在整个研究过程中，依从率下降，约一半患者在6个月的随访中退出。
在临床实践中实施混合随访是可行的。数字健康解决方案可以提供疾病演变的详细信息，使临床决策更加明智，从而改善患者结局。需要进一步研究以确定目标患者群体和参与策略。
