Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: May 8, 2020
Date Accepted: Nov 11, 2020
Use of eHealth by rheumatoid arthritis patients: an observational, cross sectional, multicenter study
ABSTRACT
Background:
The use of eHealth tools (internet, mobile applications, connected devices) in chronic diseases and in the field of rheumatoid arthritis (RA) is growing. eHealth may improve the overall quality of care of patients suffering from chronic diseases.
Objective:
The main objective of this study was to describe the use of eHealth by patients with RA in France. The secondary objectives were to identify associations between demographic and disease characteristics and eHealth tools use and also to assess patients’ expectations for eHealth.
Methods:
We conducted a cross-sectional, multicenter study. Patients with RA according to the ACR / EULAR 2010 criteria were recruited in 5 University Hospitals (Bordeaux, Clermont-Ferrand, Limoges, Montpellier and Toulouse). Patients completed an anonymous self-questionnaire including demographic data, assessment of the use of eHealth (access, support, frequency of use, type of use, reason for use). The rheumatologist in charge of the patient completed an independent medical questionnaire collecting the disease characteristics, the activity of RA and the treatments. Data were collected from December 2018 to July 2019.
Results:
The questionnaires were completed by 575 patients, with an average age of 62±13 years, 78% of whom were women. 473 (82%) patients had access to eHealth through a computer (n=402 (86%)), a tablet (n=188 (40%)) or a smartphone (n=221 (47%)). Among them, 170 (37%) used internet for health in general and 134 (29%) specifically for RA. Regarding the use of eHealth for RA, all patients used it to learn about the pathology and 89 (66%) as a tool to help monitoring RA. Most of them (n=87, (70%)) had a paper file, 24/125 patients (19%) used a digital tool (spreadsheet n=10, 8% and/or mobile application n=9, 7% and/or website n=5, 4%) and 31 patients (25%) did not use a tool to monitor their RA. Few patients (12%) used numeric reminders of treatments. A specific application for RA was used by 27 patients (21%) using eHealth. Age, level of study, employment, treatment, comorbidities, membership of a patient association and patient education program were associated with the use of eHealth for RA in univariate analysis. In multivariate analysis, membership of patient association (OR: 5.8 [3.0-11.2]), bDMARDs use (OR: 0.6 [0.4-1]) and comorbidities (OR: 0.7 [0.6-0.8]) remained associated with eHealth use for RA. According to the patients, recommendation by a doctor (n=225, 68%), ease of use (n=105, 32%) and data security (n=69, 21%) were the factors that would favor the use of eHealth.
Conclusions:
To date, few patients have used eHealth for their disease. The use of a reliable and validated eHealth tool in RA could therefore be promoted by rheumatologists and could optimize the therapeutic adherence. Clinical Trial: NCT03754855
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