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Background: Mobile applications (apps) are a major resource for information on lifestyle and general health. A healthy lifestyle is associated to improved outcomes in inflammatory arthritis. Within the longitudinal observational MeRLiN study (Meerbuscher Lebensqualitätsstudie zu Rheuma, Lebensstil und Impfungen), we therefore assessed whether targeted lifestyle counselling via app could improve disease activity in arthritis patients. Objectives: To assess whether disease activity in inflammatory arthritis is improved by lifestyle counselling via app. Methods: Mida Rheuma® app (Midaia GmbH, Germany) was made available to consecutive outpatients with inflammatory arthritis (rheumatoid arthritis (RA), spondyloarthritis (SpA), psoriatic arthritis (PsA)). Patients were alternatingly randomized to either report health-related quality of life (HRQoL) only, or to additionally receive 12 weeks of individualized lifestyle counselling via the app pertaining to a healthy Mediterranean diet, sports and physical activity, mental health, and non-smoking. Disease activity was measured with RADAI, BASDAI and DAPSA as appropriate by a physician blinded to patient allocation and categorized into remission, low, high, or moderate. A subgroup of RA also had DAS28 assessment. Statistical analysis was done by a mixed effects logistic regression adjusted to baseline disease activity, age, sex and education; the later served as a proxy for social status. Results: 158 patients (109 RA, 33 PsA, 16 SpA; 73% female, 53.3 ± 11.7 years) entered the study, 74 of whom were in the active counselling group (ACG). All patients (ACG and control group) showed improvement to be in low disease activity or remission after 12 weeks. ACG patients had an odds ratio (OR) of 2.8 (1.1-7.1, p = 0.038) while OR in the control group was not significant OR = 2.1 (0.9-5.1, p = 0.09) (Figure 1). In 43 RA patients with a DAS28-assessment, a significant reduction was noted in the ACG (β = -0.65 (-1.3 to -0.04, p = 0.046)), whereas the trend was not significant in the control group (β -0.4 (-0.9 to 0.08, p = 0.1)). No changes were noted for HRQoL measurements. Conclusion: Individualized lifestyle counselling via app may help to improve disease control in inflammatory arthritis patients. Randomized controlled trials are warranted. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests: Stefan Vordenbäumen: None declared, Tuerker Kurt: None declared, Diana Vossen: None declared, Falk Schumacher: None declared, Johannes Strunk: None declared, Dmytro Fedkov have an equity interest in Midaia GmbH, Christine Peine have an equity interest in Midaia GmbH, Felix Lang have an equity interest in Midaia GmbH, Abdullah Khalil have an equity interest in Midaia GmbH, Ralph Brinks: None declared.
Kurt et al. (Sat,) studied this question.