Self monitoring in rheumatoid arthritis using a smartphone app

Rising health care costs, increasing elderly population and shortage of personnel force us to think about alternative ways to organize our health care system. Telemedicine with self measurement of disease activity could be one of the key ingredients of the health care system of the future. The SeMoRa-3 study is a single blinded randomized controlled trial (RCT) in which patients with Rheumatoid Arthritis (RA) monitor their own disease activity with the help of a smartphone application. Patients randomized to the intervention group receive instructions, a username and a password for the MijnReumaReade smartphone app. They are instructed to complete weekly questionnaires and one outpatient clinic visit is planned at the end of the trial period. Additional follow up visits are scheduled on the basis of flares as recognized by the app or at the requests of individual patients. Patients in the standard care group continue their routine follow up visits as deemed necessary by the rheumatologist. Ultimately, the hypothesis is that after one year the disease activity is the same in both groups and the health care utilization will decline in the intervention group.

(1) patient self-monitoring is not inferior to standard of care in terms of DAS 28 score;
(2) patient self-monitoring in RA patients will reduce outpatient clinic visits, and will consequently decrease healthcare costs.

First inclusion may 2019, all patients included 2nd quarter 2020, all patients completed study 2nd quarter of 2021.

Addendum: due to the COVID-19 outbreak inclusion was stopped in april 2020 at 103 patients. With the new power analyses the non-inferiority limit has been set to 0.5. The study will have been completed by all patients by the end of april in 2021.

Self-monitoring of disease activity combined with self initiated care