Summary: Technology has revolutionized the integrated management of rheumatoid arthritis (RA) by enabling more accurate and timely diagnosis and treatment decisions through the use of electronic medical records (EMRs). Telemedicine provides remote monitoring of disease activity, while wearable devices and mobile health apps allow patients to track symptoms, and physical activity, and connect with healthcare providers. Artificial intelligence and machine learning algorithms are being used to analyze large amounts of data to develop personalized treatment plans. Additionally, RA-specific apps have emerged, providing self-management tools such as pain management and daily productivity aids. Overall, technology has significant potential for advancing health and well-being at both the individual and population levels.
What is Integrated Rheumatoid Arthritis (RA)?
Integrated, patient-centered care is a modern approach to addressing healthcare issues related to demographic changes, the increasing prevalence of chronic diseases, and restricted resources. Rheumatoid arthritis is a chronic systemic autoimmune disease that causes inflammation of joints. It initially affects small joints, progressing to larger joints, and eventually the skin, eyes, heart, kidneys, and lungs. Patients also exhibit systemic symptoms such as anemia, severe fatigue, changes in body composition, low fevers, and an increased rate of infection risks. (1) Due to the complex characteristics of the symptoms of RA and its chronic nature, the effective treatment, and management of RA requires seamless integration across the primary/secondary care interface. (2) Furthermore, since RA negatively impacts the patients in their daily and working life,(3)(4) the importance of interventions that provide support and consideration of the patient’s needs outside of the healthcare setting should not be overlooked.
How does technology support the integration of illness and self-management of an RA patient?
Technology has played a crucial role in improving the integrated management of rheumatoid arthritis (RA), a chronic autoimmune disease that causes inflammation and joint pain. From early diagnosis to ongoing disease management, technology has enabled more efficient and effective approaches to RA care. One key way technology helps is through the use of electronic medical records (EMRs) which provide clinicians with real-time access to patient data, including medical history, medication use, and test results. This allows for more accurate and timely diagnosis and treatment decisions. Telemedicine, which uses digital communication technology to connect patients with healthcare providers remotely, is another important technology in RA management. Telemedicine enables remote monitoring of disease activity, as well as providing opportunities for patient education and self-management support. Wearable devices, such as activity trackers and smartwatches, are increasingly being used to monitor patients' physical activity, sleep, and vital signs, which can provide important insights into disease progression and response to treatment.
Mobile health apps have also emerged as useful tools in RA management, providing patients with reminders to take medications, track symptoms, and connect with healthcare providers.
Finally, artificial intelligence (AI) and machine learning algorithms are being used to analyze large amounts of data to identify disease patterns and develop personalized treatment plans.
Patients spend over 99% of their time outside of the clinical environment and therefore often need to self-manage their RA. Specific self-management methods include rest, pacing, and exercise; technical aids that address occupational and daily productivity; and pain management through self-medication. A recent search identified 19 apps dedicated to RA, although the number continues to expand (5). RA apps broadly divided into those that provided calculators for rheumatologists, for example, to calculate a DAS28 score, and apps that allowed patients to track symptoms. This means treatment decisions are made using imperfect information, in turn suggesting decision-making may be suboptimal. Remote monitoring using consumer technology could be transformative in providing a clearer picture of disease through time if it could be integrated into clinical practice. Taken together, the benefits of self-management, clinical care, and research from technology have significant opportunities for advancing health and well-being at an individual and population level.
References:
O’Dell JR. Rheumatoid arthritis. In: Cecil RL, Goldman L and Schafer AI (eds) Goldman’s Cecil medicine. 24/e. Philadelphia: Elsevier/Saunders, 2012, pp.1681–1689.
Pollard LC, Graves H, Scott DL, et al. Perceived barriers to integrated care in rheumatoid arthritis: views of recipients and providers of care in an inner-city setting. BMC Musculoskelet Disord 2011; 12: 19.
Flurey CA, Morris M, Richards P, et al. It’s like a juggling act: rheumatoid arthritis patient perspectives on daily life and flare while on current treatment regimes. Rheumatology 2014; 53: 696–703.
Boonen A and Severens JL. The burden of illness of rheumatoid arthritis. Clin Rheumatol 2011; 30: 3–8.
Grainger R, Townsley H, White B, et al. Apps for people with rheumatoid arthritis to monitor their disease activity: a review of apps for best practice and quality. JMIR Mhealth Uhealth 2017; 5:e7. [PMC free article] [PubMed] [Google Scholar]Although limited to apps in New Zealand, still provides currently the best review of smartphone apps for rheumatoid arthritis (RA) self-management.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5895111/
Written by: Mr.Nikhil Sharma
Edited by: Dr.Manognya Chekragari