Improving care for arthritis patients using app technology

Somebody holding a smartphone with their apps visible.

With the REmote MOnitoring of Rheumatoid Arthritis (REMORA) project reaching its halfway point, it’s time to give an update about what we’ve achieved and what the next steps for this piece of work are.

This project was developed in partnership with The University of Manchester and Arthritis Research UK with the aim of developing a smartphone app for patients with rheumatoid arthritis (RA) to regularly log their symptoms between clinical appointments. The information captured within the app is sent directly to the patient’s electronic hospital record. At present, patients with RA are asked to recall how their condition has developed between clinical visits, but with the information captured in this app we’ll be able to accurately pinpoint disease activity over time. We’ve worked with patients, the public, clinicians, managers, IT staff and researchers to develop the app for use by patients within Salford Royal NHS Foundation Trust (SRFT) rheumatology clinics.

What have we achieved so far?

Over the past 18 months, our team has worked together with The Health eResearch Centre (HeRC) and developed the first working version of the REMORA app. During the development phase we recruited RA patients through the clinics at SRFT and consulted with them regarding what they would like to see from the app; we have so far had involvement from 27 patients. These patient views, along with the knowledge and experience of clinicians and the teams from the NIHR CLAHRC Greater Manchester, The University of Manchester, HeRC, and Arthritis Research UK, were incorporated into this first version of the app.

In March 2016 we initiated our first round of testing, which comprised of eight patients who had been involved in the consultation and development phase who were asked to spend one month using the app to record their RA symptoms. In April we held our post-testing clinic at SRFT where our eight trial patients could view the summary of their inputs into the app and discuss their experiences of using the app. We’re currently in the process of gathering feedback from all our first round trialists which we will be using to further improve the app for future use, but we’re happy to report some very positive feedback and continued enthusiasm for the project so far.

The app

The REMORA app is structured into three question sets which are answered either daily, weekly or monthly. Each question set asks for information about slightly different elements relating to RA and aims to capture information around pain, swelling and stiffness of joints, difficulties with common daily activities associated with RA, and details about how RA may be impacting on the patient’s life overall. The app also features a daily diary function so patients can capture more detailed information about their symptoms on any given day.

What are the next steps?

At present we’re still engaging and consulting with patients to ensure we’re capturing as many patients’ views as we can and incorporating them into the project. Our final patient focus group was held in June and, following this, our second testing phase began in mid-July with 24 patients testing the app for a period of three months. Between now and then, our development team will be incorporating the feedback from our first round of testing, as well as any new information and ideas that come from our patient consultations, into this second version of the app. Our post-testing clinics in this second round will take place between September and December 2016 where we’ll gain feedback to develop the app into its final version which we then hope will be used by patients and clinicians on a wider scale to improve overall patient care.

More information

View the presentation slides used in a presentation by a member of the REMORA team at The King’s Fund Digital Health and Care Conference in July 2016.

View the REMORA newsletter update from August 2016.

Contact

For more information about this project please contact John Humphreys, Project Manager.