Background In order to encourage patients to take an active role in their disease management and to enhance the dialogue between patients and healthcare providers, iMonitor was developed.1 iMonitor is a Software Medical Device developed and funded by Pfizer. Patients can complete patient-reported outcome measures (PROMs) in this online system. This allows for monitoring of disease activity in between visits, identification of patients who need medical attention in between visits, and it may lead to reduction of consultations for patients with stable disease activity. Moreover, completion of a PROM might help a patient to prepare for his or her consultation and might improve the communication between physician and patient.
Objectives This study aims to identify factors that contribute to adequate online monitoring of disease activity, by collecting experiences from patients with RA with iMonitor.
Methods Patients were recruited at Bernhoven (Uden, the Netherlands) by an announcement of the study on the hospital website, leaflets and by specific meetings. Four instruction classes were organised in which two researchers gave live instructions about the programme. Patients received log-in codes and chose their PROM-preference(s) and PROM-frequency. After nine months a focus group interview was performed and three telephone interviews were held. Questions were semi-structured using a topic list based on Flottorp2. Data will be transcribed, coded and grouped.
Results Currently 33 patients with RA are using iMonitor. Of these patients 17 (52%) attended the instruction classes and six patients (18%) attended the focus group discussion. Preliminary results reveal six themes (Technological aspects, Patient factors, Need for getting feedback, Incentives and resources, Reduction of consults and Security aspects). The Flottorp domain “Patient factors” provided most rich information. Most patients said they developed more knowledge about their disease activity and that they felt more aware about their disease activity. Additionally, iMonitor supported them in taking actions such as adjustments in lifestyle and becoming more prudent when noticing a flare. Some patients felt more prepared for a consultation and less dependent from their rheumatologist. With regard to the domain “Capacity for organisational change”, patients were confident that iMonitor could contribute to reduction of consultations, but contacting the outpatient clinic when feeling worried should be required.
Conclusions Patients' experiences with an online remote monitoring system were mainly positive. Instruction classes helped patients to get familiar with the programme. Patients experienced to have more control over their disease and to have developed more knowledge. This may result in enhanced self-management, which is important with regard to retain control over disease.
Medical and Educational Goods and Services (MEGS): iMonitor. 2014; Available from: http://www.pfizer.co.uk/content/medical-and-educational-goods-and-services-megs-imonitor.
Flottorp, S.A., et al., A checklist for identifying determinants of practice: a systematic review and synthesis of frameworks and taxonomies of factors that prevent or enable improvements in healthcare professional practice. Implementation Science, 2013. 8(1): p. 1.
Disclosure of Interest L. Renskers Grant/research support from: Pfizer, S. Rongen: None declared, A. Huis: None declared, M. Hulscher: None declared, P. van Riel Grant/research support from: Pfizer