The role of remote outpatient monitoring in the rheumatoid arthritis activity control

Introduction. The treatment strategy for rheumatoid arthritis (RA) patients involves strict monitoring of disease activity and regular consultations with a rheumatologist throughout treatment. In real clinical practice, not all patients are able to visit a doctor as frequently as necessary. Remote monitoring appears to be a promising tool for improving access to medical care.

Aim. To assess the dynamics of RA activity according to DAS28 during 12 months treatment using remote digital condition monitoring and traditional in-person observation.

Materials and methods. The study included 70 patients with RA. Patients were divided into two equal groups: remote monitoring (RM) and in-person monitoring (IPM). Patients in the RM group were assessed remotely by a rheumatologist using questionnaires in the remote monitoring program every month, as well as face-to-face visits after 6 and 12 months. In case of deterioration or insufficient positive dynamics of indicators, patients had the opportunity for remote or face-to-face consultation with a doctor and treatment adjustment. Patients in the IPM group visited a physician according to clinical guidelines at 3, 6, and 12 months. After 6 and 12 months, a comparative assessment of the dynamics and final levels of RA activity according to the DAS28 was conducted.

Results. The treatment outcomes of the RM and IPM groups were compared. Significant differences were found in the proportion of patients who achieved control of RA activity (remission and low activity) according to the DAS28 after 12 months of treatment. The remote observation group showed an advantage: 33 (94.3%) patients achieved control of RA activity, compared with 26 (74.3%) patients in the IPM group (p = 0.045).

Conclusion. The combination of remote and in-person observations in a condition monitoring was associated with a significant reduction in RA disease activity score DAS28.

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