OA38 Patients’ experiences using an integrated app for remote monitoring of rheumatoid arthritis symptoms and its impact on clinical consultations: preliminary findings from the REMORA2 study

Abstract Background/Aims The REmote MOnitoring of Rheumatoid Arthritis (REMORA) system enables people with rheumatoid arthritis to track their daily symptoms, such as pain and fatigue, via a smartphone app. It graphically presents this data integrated in the electronic health record (EHR) for review during clinical consultations, providing insight into changes in disease activity in-between clinical appointments that otherwise may be missed. The effect of the REMORA system on outcomes compared to usual care is currently being evaluated in a multicentre randomised controlled trial (REMORA2). As part of a parallel and ongoing process evaluation, we are exploring patient perceptions of using the intervention (i.e., integrated symptom tracking) and comparing their clinical consultation experience with usual care. Methods To date, we conducted semi-structured telephone interviews with patients from nine rheumatology departments participating in the REMORA2 trial allocated to the usual care (n = 10) or intervention group (n = 12), and observations of clinical consultations (usual care n = 4; intervention n = 9). Interviews and clinical consultations were audio-recorded, transcribed verbatim, analysed thematically, and triangulated. Themes were refined through discussion with the wider study team and members of the REMORA2 Patient and Public Engagement and Involvement group. Results Interview participant characteristics (n = 22): mean age 54 years (range 20-77); female n = 17 (77%); mean disease duration 12 years (range 1-35). Patients in the intervention group found it easy to register the app and use it as part of their daily routine. Being able to monitor their symptoms over time was considered a key benefit, with many willing to continue tracking long-term. Some, however, preferred handwritten notes or found tracking an unwanted reminder of their condition. All interviewees perceived integration of symptom tracking data into their EHR as potentially advantageous. Those in the intervention group confirmed that it enhanced their consultation, with the symptom data providing a more accurate picture of their condition and response to treatment. Although many considered their appointment primarily clinician-led, patients reported that discussing their symptom data made them feel more ‘listened to’. Interviews and observations suggested that the data visualisations supported recall by providing quick summaries of fluctuating symptoms during time-pressured appointments, while highlighting key symptoms for further discussion. Patients emphasised the benefits of clinicians reviewing the symptom data before the consultation, streamlining the initial part of the appointment, leaving more time for discussion and patient questions. Conclusion Patients found it easy to download the study app and track their symptoms daily. Data presented as graphs within the EHR - viewed before or during clinic - accelerated and improved understanding of disease changes through time, and of treatment response. Patients felt more listened to, and more time was spent on topics important to patients. Disclosure S.F. Moschogianis: None. J. Behan-Devlin: None. C. Sharp: None. C. Sanders: None. D.J. Griffiths-Jones: None. S.N. van der Veer: None. W.G. Dixon: None. D.G. Dowding: None.