Abstract Background/Aims The Remote Monitoring of Rheumatoid Arthritis (REMORA) system enables people living with rheumatoid arthritis (RA) and their clinicians to monitor changes in disease activity and capture symptoms that may otherwise be missed. To do this, patients enter symptom data via a smartphone app, which is integrated into electronic health records (EHRs). This holds transformative potential to improve decision-making, patient experience, disease activity, and symptom burden. However, uptake of remote monitoring is not distributed evenly across patient groups and evidence regarding the views and experiences of those who do not engage is limited. Here, we report on interviews investigating digital inclusion within the REMORA2 study, a stepped wedge cluster randomised trial testing the effectiveness of remote monitoring. This paper aims to explore barriers to app-based remote monitoring among patients who declined or who consented but did not then engage with the REMORA system. Methods Qualitative semi-structured interviews (n = 32) were conducted with patients who were invited to, but declined to participate (n = 17), or who were allocated to remote monitoring but did not start tracking on the REMORA system (n = 15). The study received NHS ethics and HRA approval, and all participants provided informed consent. Interviews were audio-recorded, transcribed verbatim and analysed thematically by three members of the team, including one patient partner investigator. Themes were refined through discussion with the wider study team and PPIE members. Results Participant characteristics: mean age was 61.8 years (range 24-82); female (n = 23) and male (n = 9); participants were White British ethnicity (n = 18), from ethnic minority groups (n = 9), White Irish (n = 4) or ethnicity not recorded (n = 1). Table 1 provides a summary of identified barriers across four themes and illustrative quotes. Conclusion These findings generate knowledge about the barriers patients face when asked to use remote monitoring technologies. Strategies seeking to address modifiable barriers, such as the timing of approach, support to use technology, and patient perceptions of remote monitoring, may improve digital inclusion and uptake of remote monitoring in RA and other long-term conditions. Disclosure J. Behan-Devlin: None. S.F. Moschogianis: None. K. Staniland: None. C. Sharp: None. D. Dowding: None. S.N. van der Veer: None. W. Dixon: None. C. Sanders: None.
Devlin et al. (Wed,) studied this question.