Telemonitoring met SpA-Net

Spondyloarthritis (SpA) is a chronic inflammatory rheumatic disease with a heterogeneous presentation. Regular and personalised monitoring of disease activity, physical functioning, medication use and side effects is essential to improve and maintain patients’ health-related quality of life (HRQoL) in SpA. Furthermore, care provided should be patient-centred, involving patients in treatment decisions and incorporating personal preferences, needs and values. Increasingly, transparency on outcomes of care delivered and efficiency of care are demanded. In daily practice, capacity issues, time constraints, lack of optimal tools for monitoring and providing transparency may hinder these important aspects of quality of care. Traditionally outpatient visits are pre-booked every 3-6 months, but these are frequently unnecessary in stable patients with low disease activity. Remote monitoring through a web application (telemonitoring) could be a solution for these patients. Telemonitoring has been shown to be possible, effective and safe in several chronic diseases, and clearly reduced health care utilization. To date, this has never been tested in SpA. In 2016, a web-based eHealth system for patients with SpA in the Netherlands (‘SpA-Net’) was developed as a personal monitoring system. SpA-Net includes clinical information on medication use, laboratory tests, several patient reported outcomes and a personal treatment plan, providing a comprehensive view of the patient for the rheumatologists. An excerpt of this is available to patients. This serves as the basis for each outpatient consultation. Since 2016, SpA-Net has been increasingly used in daily practice. Focus interviews among patients and care providers showed high satisfaction and acceptance of SpA-Net. It is, however, unknown whether SpA-Net can also be used as a telemonitoring system, thereby replacing face-to-face consultations, and leading to a reduction in health care utilisation. In this study, remote care (telemonitoring) provided through SpA-Net, in combination with patient-initiated care, is compared with standard care, aiming at more efficient care. Concomitantly, a trial-based cost-utility analysis will be performed.

We hypothesize that telemonitoring through SpA-Net, in combination with patient-initiated care, will lead to less outpatient visits, without compromising quality of care and health outcomes. Furthermore, we expect that telemonitoring through SpA-Net could reduce healthcare expenditures and/or societal costs.

Inclusion period December 2020 – July 2021 Follow up period December 2020 – July 2022 Data analysis, manuscript preparation July 2022 – January 2023 Cost-effectiveness analysis January 2023 – July 2023

Asynchronous telemonitoring (met behulp van SpA-Net) in combinatie met patiënt-geïnitieerde zorg