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Randomized Controlled Trial
. 2025 Jan 1;64(1):310-320.
doi: 10.1093/rheumatology/kead709.

Effect of digital monitoring and counselling on self-management ability in patients with rheumatoid arthritis: a randomised controlled trial

Linda C Li  1 , Hui Xie  2 , Lynne M Feehan  1 , Chris Shaw  3 , Na Lu  4 , Smruthi Ramachandran  1 , Ellen Wang  1 , Stephanie Therrien  4 , Julia Mucha  1 , Alison M Hoens  1 , Kelly English  4 , Eileen Davidson  4 , Teresa Liu-Ambrose  1 , Catherine L Backman  5 , John M Esdaile  4 , Kimberly J Miller  6 , Diane Lacaille  4
Affiliations
Randomized Controlled Trial

Effect of digital monitoring and counselling on self-management ability in patients with rheumatoid arthritis: a randomised controlled trial

Linda C Li et al. Rheumatology (Oxford). .

Abstract

Objectives: To assess a remote physiotherapist (PT) counselling intervention using self-monitoring tools for improving self-management ability, physical activity participation and health outcomes in people with rheumatoid arthritis (RA).

Methods: Eligible participants were randomly assigned to receive group education, a Fitbit®, a self-monitoring app, and PT counselling phone calls (Immediate Group). The Delayed Group received a monthly e-newsletter until week 26, and then the intervention. The primary outcome was Patient Activation Measure (PAM-13). Participants were assessed at baseline, 27 weeks (the primary end point) and 53 weeks. Secondary outcomes included disease activity, pain, fatigue, depression, sitting/walking habits, daily physical activity time and daily awake sedentary time. Generalized Linear Mixed-effect Models (GLMMs) were used to assess the effect of the intervention on the change of each outcome measure from the initiation to 27 weeks after the intervention.

Results: Analysis included 131 participants (91.6% women; 80.2% completed during the COVID-19 pandemic). The mean change of PAM-13 at 27 weeks was 4.6 (Standard Deviation [SD] = 14.7) in the Immediate Group vs -1.6 (SD = 12.5) in the Delayed Group. The mean change in Delayed Group at 53 weeks (after the 26-week intervention) was 3.6 (SD = 14.6). Overall, the intervention improved PAM-13 at 27 weeks post-intervention from the GLMM analysis (adjusted coefficient: 5.3; 95% CI: 2.0, 8.7; P ≤ 0.001). Favourable intervention effects were also found in disease activity, fatigue, depression and self-reported walking habit.

Conclusion: Remote counselling paired with self-monitoring tools improved self-management ability in people with RA. Findings of secondary outcomes indicate that the intervention had a positive effect on symptom management.

Keywords: e-health; patient activation; physical activity; rheumatoid arthritis; self-management; self-monitoring.

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Figures

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Graphical abstract
Figure 1.
Figure 1.
Consolidated Standards of Reporting Trials (CONSORT) flowchart
Figure 2.
Figure 2.
Changes in Patient Activation Measure in both groups across time
See this image and copyright information in PMC

References

    1. Barlow J, Wright C, Sheasby J, Turner A, Hainsworth J.. Self-management approaches for people with chronic conditions: a review. Patient Educ Counsel 2002;48:177–87. - PubMed
    1. Lawless MT, Tieu M, Feo R, Kitson AL.. Theories of self-care and self-management of long-term conditions by community-dwelling older adults: a systematic review and meta-ethnography. Soc Sci Med 2021;287:114393. - PubMed
    1. Ross R, Chaput J-P, Giangregorio LM. et al. Canadian 24-hour movement guidelines for adults aged 18–64 years and adults aged 65 years or older: an integration of physical activity, sedentary behaviour, and sleep. Appl Physiol Nutr Metabol 2020;45:v–xi. - PubMed
    1. Martínez N, Connelly CD, Pérez A, Calero P.. Self-care: a concept analysis. Int J Nurs Sci 2021;8:418–25. - PMC - PubMed
    1. Hibbard JH, Stockard J, Mahoney ER, Tusler M.. Development of the Patient Activation Measure (PAM): conceptualizing and measuring activation in patients and consumers. Health Serv Res 2004;39:1005–26. - PMC - PubMed

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