Evaluation of a Connected Interface to Improve the Quality of Life and the Disability of Patient With Rheumatic Diseases

Musculoskeletal pathologies constitute a major public health problem. Rheumatologists, whether they practice in private or hospital settings, play a major role in the management of responsible for these ailments.

Due to the increase in life expectancy, an increase in the number of consultations can be expected. It is therefore imperative that the latter be more efficient, without losing quality.

Communication between doctor and patient is bound to evolve due to the multiplicity of IT tools available and those that are emerging, which are increasingly essential, including many smartphone applications. Each targeting a specific pathology (rheumatoid arthritis, ankylosing spondylitis, osteoporosis osteoarthritis, they will allow the patient to self-assess, thus becoming an actor in his own care.

A "facilitated" exchange between caregivers and patients would be relevant and would provide added value for all. This is the reason why there is a real need for an application listing precise information on the patient, in a sufficiently succinct way to optimize their transmission to the physiotherapist.

Our team has recently highlighted that monitoring rheumatoid arthritis in connected mode (smartphone + online interface for the physician + distancing interaction patient / caregiver) provided a benefit in terms of quality of life as well as on the medico-economics level compared to conventional monitoring, without affecting the control of rheumatoid arthritis activity. Telemedicine is positioned more than ever as an essential instrument for organizing the longitudinal monitoring of diseases, especially in a context of confinement, which implies limited access to physiotherapy sessions, even though these are essential for optimizing the management of many osteoarticular disorders. By promoting the use of a digital telemedicine tool in the follow-up of patients suffering from rheumatological pathologies in both private practice and hospitals, the Rhumato-App project aims to develop an ergonomic offline/online platform for patients/healthcare providers (e.g. rheumatologist, general practitioner, physiotherapist), accessible from a computer or a smartphone. This platform will improve the articulation of the patient's care pathway by feeding a secure medical file shared between caregivers.

The experimental intervention consists in providing the patient with access to a specific version of the application ''MedicApp'' for the duration of the study.

The intervention will be limited for each patient to the entry of their data on the application at regular intervals during the study.

The interface on the rheumatologist side will contain the demographic characteristics of the patient, his history, the treatments and the pathology requiring the use of physiotherapy Then, at regular intervals, the scores of the questionnaires addressed to the patient will be available on his interface. The interface, on the physiotherapist side, will contain the summary of the patient's clinical history, his treatments and the reason for the physiotherapy sessions. Then, at regular intervals, the physiotherapist will indicate the patient's locomotor assessment, the type of intervention performed and the final summary.

Device: use of an e-health application

Use of the e-health application throughout the duration of the study combined with the usual management of the disease and 20 physiotherapy sessions.

Time frame: between baseline and 6 months

Evaluate the impact of the computer interface on the patient's quality of life by comparing the evolution of the global SF-12 score between baseline and 6 months (longitudinal follow-up).

The Survey Form-12 (SF-12) is a self-reported outcome measure assessing the impact of health on an individual's everyday life.

The SF-12 is a shortened version of SF-36.

The SF-12 have eight domains :

1. Limitations in physical activities because of health problems.
2. Limitations in social activities because of physical or emotional problems
3. Limitations in usual role activities because of physical health problems
4. Bodily pain
5. General mental health (psychological distress and well-being)
6. Limitations in usual role activities because of emotional problems
7. Vitality (energy and fatigue)
8. General health perceptions

Time frame: between inclusion and 6 months

To assess the patient's satisfaction with the use of this device at the end of the 6-month follow-up with the F-SUS (French System Usability Scale) questionnaire.

The F-SUS (French System Usability Scale) is a 10-items, to determine the level of satisfaction of users of a service and the usability of the interactive system of the study.

Score range from 1 to 5 with 1=totally disagree and 5=totally agree

Time frame: between baseline and 6 months

Evaluate the patient's adherence to the use of a computer interface based on the weekly filling rate during the 6-month follow-up

Time frame: between baseline and 6 months

Assess the association between patient adherence and change in disease activity level between baseline and 6 months

Time frame: between baseline and 6 months

Evaluate the association between patient compliance and the variation in their quality of life between baseline and 6 months

Time frame: between baseline and 6 months

Assess the association between patient adherence and satisfaction at 6 months

Time frame: between baseline and 6 months

Assess the satisfaction of caregivers (physiotherapist, rheumatologist) with the use of this device at the end of the 6-month follow-up

Evaluation of a Connected Interface (Rheumatologist, Physiotherapist, Patient) to Improve the Quality of Life and the Disability of Patients With Rheumatic Diseases