THU0581 USE OF EHEALTH BY PATIENTS WITH RHEUMATOID ARTHRITIS: AN OBSERVATIONAL, CROSS SECTIONAL, MULTICENTER STUDY

Abstract

Background: The use of eHealth tools (internet, mobile applications, connected devices) in chronic diseases and in the field of rheumatoid arthritis (RA) is growing (1). eHealth may improve the overall care of patients suffering from chronic diseases (2,3). Objective(s): The main objective of this study was to describe the use of eHealth by RA patients in France. The secondary objectives were to identify differences in demographic and disease characteristics between patients using eHealth tools or not. We also assessed patients' expectations about digital devices. Method(s): We conducted a cross-sectional, multicenter study. Patients with RA according to the ACR / EULAR 2010 criteria were recruited in 5 university hospitals (Bordeaux, Clermont-Ferrand, Limoges, Montpellier and Toulouse). Patients completed an anonymous self-questionnaire including demographic data, assessment about the use of eHealth (access, support, frequency of use, type of use, reason for use). The treating rheumatologist of the patient filled in an independent medical questionnaire collecting the disease characteristics, the activity of RA and the treatments. Data were collected from December 2018 to July 2019. Result(s): The questionnaires were completed by 575 patients, with an average age of 62+/-13 years, 78% of whom were women. 473 (82%) patients had access to eHealth through a computer (n=402, 86%), a tablet (n=188, 40%) and/or a smartphone (n=221, 47%). Among them, 36% (170/473) used internet for health in general and 29% (134/473) specifically for RA. Regarding the use of eHealth for RA, all patients used it to learn about their disease and 66% (89/134) as a tool to help monitoring RA. Most of them (n=87/125, 70%) had a paper medical record, 24/125 patients (19%) used a digital tool (spreadsheet n=10, 8% and / or mobile application n=9, 7% and / or website n=5, 4%) and 31/125 patients (25%) did not use any tool to monitor their RA. Few patients (16/126, 13%) used numeric reminders for their treatments. A specific application for RA was used by 27/127 patients (21%) using eHealth. Age, level of study, employment, treatment, comorbidities, membership of a patient association group and patient education program were associated with the use of eHealth for RA in univariate analysis. In multivariate analysis, membership of patient's association (OR: 5.8 [3.0-11.2]), bDMARDs use (OR: 0.6 [0.4-1]) and comorbidities (OR: 0.7 [0.6-0.8]) remained associated with eHealth use for RA. According to the patients, recommendation by a doctor (n=225/330, 68%), ease of use (n=105/330, 32%) and data security (n=69/330, 21%) were the factors that would favor the use of eHealth. Conclusion(s): To date, few patients used eHealth for their disease. The use of a reliable and validated eHealth tool in RA could therefore be promoted by rheumatologist and might optimize the therapeutic adherence.