Patient Engagement With Digital Health Tools in Rheumatology

Guy's and St Thomas' NHS Foundation Trust3,000 enrolled

Overview

The purpose of this study is to evaluate the patient engagement with digital tools for diagnosis and monitoring of disease in rheumatology services

The investigators plan to undertake a mixed methods study to investigate a digital algorithm to potentially inform triage of new patient referral to rheumatology services, as well as to inform follow up review schedules. Current practice at out hospital is to ask all newly referred patients to complete a pre-appointment digital questionnaire prior to their clinic visit. Patients who need follow up are then routinely invited to continue to return interval questionnaires related to their symptoms between clinic visits. The investigators believe that the questionnaire responses could enable appropriate (and safe) allocation to a particular clinic (e.g. urgent early arthritis clinic or general rheumatology clinic for a new referral), or define an appropriate clinic follow up interval for a repeat visit for patients with a rheumatic disease. Our study aims to evaluate these questionnaires using data collected from routine clinical practice, as well a series of semi-structured interviews with service users.

Study Type

OBSERVATIONAL

Enrollment

3,000

Conditions

Rheumatic Disease PROM

Interventions

QuestionnaireOTHER

Questionnaires completed as part of routine care - this is an observational study

Semi-structured interviewOTHER

Semi-structured interview to review factors involved in patients engaging or not-engaging with the digital tools

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: quantitative phase: * Aged 18 years and above * Able to complete the questionnaire in English 1\. New patient pre-appointment questionnaires * Referred as a new patient to the rheumatology outpatient department at Guys and St Thomas' Trust between 01/01/2019 to 01/10/2023 and sent a digital pre-appointment questionnaire * Electronic patient notes recorded between 01/01/2019 to 01/10/2024 2\. Follow up patients PROM questionnaires * Patients under followup of the rheumatology department at Guys and St Thomas' Trust with a diagnosis of rheumatoid arthritis, psoriatic arthritis or axial spondyloarthropathy who have been added to the remote monitoring program between 01/01/2019 to 01/10/2023 * Electronic patient notes recorded between 01/01/2019 to 01/10/2024 Inclusion criteria: qualitative phase: * Aged 18 years and above 1\. New patient pre-appointment questionnaires * Referred as a new patient to the rheumatology outpatient department at Guys and St Thomas' Trust between 01/01/2019 to 01/10/2023 and sent a digital pre-appointment questionnaire * Able to communicate in English or any language offered for audio interpreting by the LanguageLine service 2\. Follow up patients PROM questionnaires * Patients under followup of the rheumatology department at Guys and St Thomas' Trust with a diagnosis of rheumatoid arthritis, psoriatic arthritis or axial spondyloarthropathy who have been added to the remote monitoring program between 01/01/2019 to 01/10/2023 * Able to communicate in English or any language offered for audio interpreting by the LanguageLine service Exclusion Criteria: quantitative phase: * Under 18 years of age * Unable to complete study questionnaires Exclusion criteria: qualitative phase: * Under 18 years of age * Patients lacking the capacity to consent for themselves for the semi-structured interview

Outcomes

Primary Outcomes

Number of patients with a non-inflammatory diagnosis

Clinician assessed diagnosis as categorised into inflammatory \[e.g. rheumatoid arthritis\] or non-inflammatory \[e.g osteoarthritis or fibromyalgia\]

Time frame: 3 years

Clinician assessed DAS-28 score for patients with rheumatoid arthritis

Clinician assessment of disease activity at next follow-up visit for remote monitoring questionnaires

Time frame: 3 years

Clinician assessed PsARC score for patients with psoriatic arthritis

Clinician assessment of disease activity at next follow-up visit for remote monitoring questionnaires

Time frame: 3 years

Rate of response to digital questionnaires

Proportion of patients completing the new patient pre-appointment and follow-up remote monitoring questionnaires.

Time frame: 3 years

Secondary Outcomes

PHQ8 scores in new patients completing pre-appointment questionnaires

To estimate the prevalence of depression in new referrals to the rheumatology service. Score range 0 to 24, with higher score indicating more severe depression

Time frame: 3 years

GAD7 scores in new patients completing pre-appointment questionnaires

To estimate the prevalence of anxiety in new referrals to the rheumatology service. Score range 0 to 21, with higher score indicating more severe anxiety

Time frame: 3 years

Central Contacts

Nikita Arumalla, MBBS, BSc

CONTACT

07834958748 nikita.arumalla@gstt.nhs.uk

Data from ClinicalTrials.gov

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