Disease activity, structural damage, and progression all impact the lives of people with rheumatoid arthritis (RA), and can cause psychosocial distress. While inhibition of inflammation and structural changes have improved significantly following advances in pharmacological treatment in recent dates, the observed impact of these disease-modifying antirheumatic drugs (DMARD) on key psychosocial outcomes is limited.3 An important feature within the EULAR recommendations on self-management in people with inflammatory arthritis is that digital healthcare is tagged as being essential in supporting and optimising self-management2. . Thus healthcare professionals need to be aware of available resources in order to direct patients to the most appropriate websites and apps.
RECLARIT is an internet-based digital health app designed for people with RA.4 The app provides methods and exercises – often relying on cognitive-behavioural therapy – and follows a holistic approach in order to support people to enhance their mental quality of life. But there is a need to show that such resources are effective. To address this, a two-armed randomised controlled trial was conducted in Germany, with 354 adult RA patients assigned to use RECLARIT in addition to standard of care, or standard of care alone. The primary endpoint was the change in health-related quality of life (HRQoL) from baseline to Month 3, as measured by the SF-36 mental component summary (MCS) score. Secondary endpoints included depression, anxiety, fatigue, social work-related functioning, pain, physical function, and safety.
The results – presented at the 2024 EULAR congress by Frank Behrens – showed that at 3 months HRQoL was significantly higher in those using RECLARIT versus standard of care alone, and this effect was maintained at 6 months. Secondary endpoints related to psychosocial HRQoL also showed significant improvement in those using RECLARIT, although there were no significant differences seen in pain or physical function.
These findings suggest that using the digital health app significantly improved people's psychological HRQoL, with stable effects maintained to 6 months. This aligns with the EULAR position, that including self-management advice and resources in routine management, and aiming to empower and support patients with a more holistic approach to care could result in improved patient experience of care and outcomes.2
Source
Jacob G, et al. A cognitive behavioural digital health application is effective in improving psychological quality of life in patients with rheumatoid arthritis. Presented at EULAR 2024; OP0097-HPR.
Ann Rheum Dis 2024; DOI: 10.1136/annrheumdis-2024-eular.5344.
References
1. Marques A, et al. Effectiveness of self-management interventions in inflammatory arthritis: a systematic review informing the 2021 EULAR recommendations for the implementation of self-management strategies in patients with inflammatory arthritis. RMD Open 2021;7(2):e001647.
2. Nikiphorou E, et al. 2021 EULAR recommendations for the implementation of self-management strategies in patients with inflammatory arthritis. Ann Rheum Dis 2021;80(10):1278–85.
3. Matcham F, et al. The impact of targeted rheumatoid arthritis pharmacologic treatment on
mental health: a systematic review and network meta-analysis. Arthritis Rheumatol 2018;70(9):1377–91.
4. RECLARIT. https://www.reclarit.de/
About EULAR
EULAR is the European umbrella organisation representing scientific societies, health professional associations and organisations for people with rheumatic and musculoskeletal diseases (RMDs). EULAR aims to reduce the impact of RMDs on individuals and society, as well as improve RMD treatments, prevention, and rehabilitation. To this end, EULAR fosters excellence in rheumatology education and research, promotes the translation of research advances into daily care, and advocates for the recognition of the needs of those living with RMDs by EU institutions.
