Early detection of rheumatoid arthritis through patient empowerment by tailored digital monitoring and education: a feasibility study.

Abstract

Patients at risk for rheumatoid arthritis (RA) describe fluctuating and nonspecific symptoms, making it difficult to quantify symptom burden and recognize RA progression. This study aimed to assess feasibility and diagnostic value of a multimodal digital self-monitoring program in preclinical RA. This prospective cohort study included individuals at-risk for RA, who first watched self-produced educational videos about (preclinical) RA and joint self-examination techniques and then started the REMOTRA symptom monitoring. Key outcomes measured included patient acceptance (Net Promoter Score: NPS), monitoring program usability (System usability scale: SUS), monitoring adherence, diagnostic accuracy, and reported symptom burden. A total of 43 participants (65.9% female, mean age 50.1 years) were enrolled. The educational and self-examination videos received NPS ratings of 54.4 and 31.6, respectively. The monitoring software received usability scores of 88.1/100 (SD: 5.5) at three months and 85.4/100 (SD: 16.0) at 6 months. 24/41 (58.5%) completed all questionnaires, and the average app usage was 4.8 months (SD: 1.8). None of the patients with a REMOTRA score below 10 developed RA, yielding a negative predictive value and sensitivity of 100%. However, the positive predictive value was 12%, and the specificity was 42.1%. Analgesic and cortisone usage was reported by 58.5% and 29.3% of participants, respectively. The strong patient acceptance, ease of use, and high adherence rates, combined with encouraging diagnostic outcomes, underscore the potential of this personalized digital monitoring and education approach. These findings suggest that further validation through multicenter studies is warranted.