Challenges in the Treatment of Rheumatoid Arthritis (RA)
RA Is often difficult to treat or manage, and some patients do not achieve treatment goals set by providers. Known factors such as the presence of auto-antiantibodies, joint erosion, genetics, comorbidities, extra-articular manifestations, and pregnancy can influence the effectiveness of treatments.
RA Symptoms can vary over time. Providers often see their patients at three to six-month intervals with patients failing to recall or not report the symptoms experienced between visits. Data collected from digital technology may present providers and patients with the necessary information to develop more effective treatment plans, placing patients in an acceptable range on the 28-joint disease activity score (DAS28). In assessing this activity score it is critical for patients to not only participate in treatment-making decisions but also in the assessment of their disease activity.
Disease Activity Score 28
- <2.6 Suggests Disease Remission
- 2.6-3.2 Suggests Low Disease Activity
- 3.2-5.1 Suggests Moderate Disease Activity
- >5.1 Suggests High Disease Activity
Treat-to-target is the recommended strategy in the management of RA that requires a standardized assessment that includes findings from both the health care provider and the patient. The challenge is treatment decision-making is not completely consistent with the treat-to-target approach, and failure to regularly assess disease activity using standardized tools remains a major obstacle.
Patient-Reported Outcomes (PROs) & Digital Technology
The utilization of PROs in digital applications has been increasingly effective in the management of RA, allowing patients to record symptoms and consult with providers. Many PROs digital apps utilize core variables that include:
- Pain
- Physical function
- Remission
- Flare up.
These applications are rapidly transforming the landscape in the treatment of many chronic conditions, but the use of digital health applications in diseases with more varied treatment targets, such as RA, is still being studied and showing promising results.
Assessing the Efficacy of Digital Applications in Managing RA
In the spring of 2023, the JAMA Network published the results of two randomized clinical trials conducted to examine the efficacy of smartphone health applications in patients with RA.
In this randomized clinical trial involving 2,197 patients with rheumatoid arthritis, the use of a smartphone application for assessing patient-reported outcomes resulted in a statistically significant increase in the rate of achieving a DAS28-CRP score of 3.2 or less at the 6-month mark.
The findings suggest that assessing PROs using a smartphone application resulted in clinical improvement in disease activity for patients with RA. The study also revealed a reduction in rheumatologist consultations, a benefit with limited providers and appointment availability, and positive experiences were confirmed by the patients.
Offering Solutions in the Management of RA
RPM Healthcare offers digital technology assisting patients and providers in the management of RA. Designed by physicians, RA Monitor is an app that allows patients to record their symptoms, medications, and appointments. The app sends out the latest news on RA, along with inspirational messages to help patients on their journey to improving their quality of life.
RPM Healthcare revolutionizes healthcare delivery with our reimbursable remote coaching and monitoring program. Our digital health solutions extend patient care beyond the traditional medical office, enhancing the patient experience, improving clinical outcomes, and ensuring patient safety. We reduce workflow disruptions with our team’s engagement, ensuring treatment adherence, accurate documentation, and effective triaging. RPM delivers significant improvements in patient outcomes, effective condition management, and reduced costs, helping healthcare providers overcome today’s challenges.
All information has been reviewed by Irina Koyfman, DNP, NP-C, RN, Chief Population Health Officer, RPM Healthcare.
