BACKGROUND
The use of eHealth tools (the Internet, mobile applications, connected devices) in chronic diseases and in the field of rheumatoid arthritis (RA) is growing. eHealth may improve the overall quality of care of patients suffering from chronic diseases.
OBJECTIVE
The main objective of this study was to describe the use of eHealth by RA patients in France. The secondary objectives were to identify associations between demographic and disease characteristics and eHealth tools use and also to assess patients’ expectations for eHealth.
METHODS
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 of the use of eHealth (access, support, frequency of use, type of use, reason for use). The rheumatologist in charge of each patient completed an independent medical questionnaire collecting the disease characteristics, the activity of RA and the treatments. Data was collected between December 2018 and July 2019.
RESULTS
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%)) or a smartphone (n=221 (47%)). Among them, 170 (37%) used the Internet for health in general and 134 (29%) specifically for RA. Regarding the use of eHealth for RA, all patients used it to learn about the pathology and 89 (66%) as a tool to help monitoring RA. Most of them (n=87, (70%)) had a paper file, 24/125 patients (19%) used a digital tool (spreadsheet n=10 or mobile application n=9 or website n=5) and 31 patients (25%) did not use any tools to monitor their RA. Few patients (12%) used numeric reminders of treatments. A specific application for RA was used by 27 patients (21%) using eHealth. Age, level of study, employment, treatment, comorbidities, membership of a patient association and patient education program were associated with the use of eHealth for RA in univariate analysis. In multivariate analysis, membership in a patient 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 the use of eHealth for RA. According to patients, recommendation by a doctor (n=225, 68%), ease of use (n=105, 32%) and data security (n=69, 21%) were the factors that would favor the use of eHealth.
CONCLUSIONS
To date, few patients have used eHealth for their disease. The use of a reliable and validated eHealth tool in RA could therefore be promoted by rheumatologists and could optimize the therapeutic adherence.
CLINICALTRIAL