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SAT0757-HPR Significant improvement of rheumatoid arthritis (RA) outcome with repeated self-assessment applying smart system of disease management (SSDM) mobiles tools: a cohort study of RA patients in china
  1. J Yang1,
  2. Y Wang2,
  3. F Li3,
  4. H Wei4,
  5. J Xue5,
  6. H Wang6,
  7. J Ru7,
  8. R Mu8,
  9. J Huang9,
  10. X Zuo10,
  11. X Xin11,
  12. F He12,
  13. X Shi13,
  14. Z Li14,
  15. F Xiao15,
  16. H Xiao15,
  17. Y Liu15,
  18. Y Jia15,
  19. Z Li8
  1. 1Department of Rheumatology, Central Hospital of MianYang, Sichuan, Mianyang
  2. 2Department of Rheumatology, The First Affiliated Hospital of BaoTou Medical College, Baotou
  3. 3Department of Rheumatology and Immunology, The Second Xiangya Hospital of Central South University, Changsha
  4. 4Department of Rheumatology, Northern Jiangsu People's Hospital, Yangzhou
  5. 5Department of Rheumatology and Immunology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou
  6. 6Department of Rheumatology and Immunology, JiaXing First Hospital, Zhejiang, Jiaxing
  7. 7Dept.of Rheumatology, The 264th Hospital of the PLA, Taiyuan
  8. 8Department of Rheumatology and Immunology, People's Hospital, Beijing University Medical School, Beijing
  9. 9Department of Rheumatology and Immunology, The sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou
  10. 10Department of Rheumatology and Immunology, Xiangya Hospital Centeral South University, Changsha
  11. 11Ningbo First Hospital, Zhejiang, Ningbo
  12. 12Department of Rheumatology, Suining Central Hospital, Suining
  13. 13Department of Rheumatology and Immunology, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang
  14. 14Department of rheumatology, The First Affiliated Hospital of Bengbu Medical College, Bengbu
  15. 15Medical Department, Shanghai Gothic Internet Technology Co., Ltd., Shanghai, China

Abstract

Background There are more than 5 million RA patients in China, but only 5,000 rheumatologists. Treat-to-Target (T2T) strategy are critical for the treatment of RA, but the Chinese rheumatologists can hardly provide patients with a complete assessment in the clinic due to limited time. The SSDM includes interfaces of both physicians' and patients' application. After entering the data of lab test records, treatment regiments, and executing DAS28 assessment by patients themselves, all data can be synchronized automatically to the authorized physicians' mobile tool. The rheumatologists can adjust treatment regiments base on patients' profile. Our previous study showed that patients in China can master the application of SSDM for accurately evaluating DAS28 and health assessment questionnaire (HAQ) after training.

Objectives The purpose of this study is to explore the effectiveness of applying SSDM in improvement of disease activity after repeated self-assessment in Chinese RA patients.

Methods Patients were educated to assess DAS28 with SSDM and asked to repeat the self-assessment once a month. Descriptive statistics were performed for patient and disease characteristics. According to DAS28 scores, disease activity was divided into four groups: remission (Rem), low disease activity (LDA), moderate disease activity (MDA) and high disease activity (HDA).

Results From Aug 2014 to Jan 2017, a total of 11,867 RA patients from 459 centers in China participated in the study. The mean age was 49.27±14.35 (18 to 99) years and the median disease duration was 11.43 months. All patients performed self-assessment of DAS28, HAQ and morning stiffness time for 20,376 times. Proportion of patients in Rem, LDA, MDA and HDA was 16%, 12%, 46% and 25% respectively at baseline. Of which, 3,472 patients performed repeated assessment for 8,509 times. Proportion of patients in Rem, LDA, MDA and HDA changed into 34%, 18%, 38% and 10% at the last assessment. The proportion of T2T (DAS28 <3.2) at the last assessment was higher than that of baseline significantly (P<0.001). According to the assessments, the rate of T2T from baseline to 6 times were 28%, 41%, 49%, 51%, 56% and 58% (see Figure 1).With the increase of the times of self-assessment, the T2T rate was significantly improved (p<0.001).

Conclusions Under repeated self-assessment of DAS28 using SSDM, RA patients can achieve better T2T result. SSDM can assist rheumatologist to rationally adjust treatment for RA patients.

Disclosure of Interest None declared

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