Remote monitoring in rheumatoid arthritis v1
Research type
Research Study
Full title
Remote monitoring of disease and physical activity in rheumatoid arthritis: a pilot study
IRAS ID
313072
Contact name
Kenneth Baker
Contact email
Sponsor organisation
The Newcastle upon Tyne Hospitals NHS Foundation Trust
Duration of Study in the UK
0 years, 10 months, 30 days
Research summary
Research Summary:
Rheumatoid arthritis is a common disease affecting 1 in 100 UK adults, causing joint pain, stiffness and fatigue. Patients with rheumatoid arthritis need close monitoring of their arthritis activity to work out the most effective dose of their arthritis drugs. At the moment, this monitoring is done at clinic visits, meaning that patients have to regularly attend hospital. If it were possible for patients to be monitored remotely, this would avoid many trips to hospital and free up clinic appointments for those patients most in need.
In this small study, we aim to assess the feasibility of remote monitoring in patients with active rheumatoid arthritis who are starting an arthritis drug. We will invite 20 patients to take part and will be followed for three months. Patients will complete self-assessments of their arthritis activity using online questionnaires, and their physical activity and heart/breathing rate will be measured using small wearable monitors. Patients will also attend for monthly face-to-face visits with a nurse to assess their arthritis activity using standard measurements used in current clinical practice. We will compare remote measurements of arthritis activity with standard face-to-face assessments to assess their accuracy and reliability. Also, information from activity and heart/breathing rate monitors will be analysed to look for patterns that may identify when patients have active arthritis. Finally, patients will provide feedback on their experience of remote monitoring, and any aspects for future improvement.
Our findings will be used to support future funding applications for larger studies to examine the use of remote monitoring to guide drug treatment in patient with rheumatoid arthritis. If successful, such remote monitoring would benefit patients by empowering them to measure their own arthritis activity at home, avoiding additional hospital visits, and providing their healthcare team with more detailed information to better treat their arthritis.
Summary of Results:
Rheumatoid arthritis is a common disease affecting around 1% of UK adults. The disease causes painful swelling and stiffness in the joints, joint damage and extreme tiredness. Often rheumatoid arthritis fluctuates from day-to-day, with sudden increases in arthritis activity known as “flares”. Being able to accurately measure disease activity is important to detect these flares, and to make sure patients are taking the right type and dose of arthritis drugs to control their condition.Currently, the main way of measuring arthritis activity is to assess patients in face-to-face hospital visits. This means frequent trips to hospital, which is inconvenient for patients and takes up valuable clinic appointments. Also, flares that happen between clinic visits can be easily missed. A reliable way of continuously measuring disease activity remotely without extra hospital visits would allow a better level of arthritis monitoring, and be better for patients and healthcare providers.
In this study, we explored the use of wearable devices to measure disease activity in rheumatoid arthritis. We invited people with rheumatoid arthritis who were newly starting an arthritis drug to take part. Participants were seen in clinic appointments once every month for 3 months where their arthritis activity was measured by a rheumatology doctor. For 7 days after each visit, participants were asked to wear two different devices. One of these was the Axivity AX6 device, which measures physical activity and was worn at the lower back and wrist. The other was the VitalPatch device, which measures heart and breathing rate and was worn on the upper chest. The Axivity AX6 device records data internally, whereas the VitalPatch device transmits data by Bluetooth to a mobile phone. Participants also completed an online weekly questionnaire to measure their arthritis symptoms.
Twelve participants took part in the study, of whom 11 completed the full 3-month follow-up. We got good quality data from the Axivity devices, with some measurements showing associations with arthritis disease activity. We found the quality of the data was still very good even when the recording was reduced to one-quarter speed. This is important as slower recording speeds mean the devices can record for longer. Unfortunately, the VitalPatch data was of lower quality, mainly due to technical problems with data linkage between the patch and the mobile phone. Feedback from the people who took part suggested that the wrist-worn Axivity device was the easiest and most convenient to use.
Our results show that using these wearable devices is feasible and may provide a way of remotely measuring disease activity in patients with rheumatoid arthritis. Further research is needed to understand which measurements from these devices is best to use, and how accurate they are compared to traditional face-to-face assessments. Based on our results, we are now conducting a larger research study using wrist-worn Axivity AX6 devices in patients with rheumatoid arthritis to see if they can detect rheumatoid arthritis flares.
REC name
North of Scotland Research Ethics Committee 1
REC reference
22/NS/0072
Date of REC Opinion
17 May 2022
REC opinion
Favourable Opinion