1. Improvement of Disease Management and Cost Effectiveness in Chinese Patients with Ankylosing Spondylitis Using a Smart-Phone Management System: A Prospective Cohort Study.
- Author
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Ji, Xiaojian, Wang, Yiwen, Ma, Yingpei, Hu, Zhengyuan, Man, Siliang, Zhang, Ying, Li, Kunpeng, Yang, Jinshui, Zhu, Jian, Zhang, Jianglin, and Huang, Feng
- Subjects
NONSTEROIDAL anti-inflammatory agents ,ANKYLOSING spondylitis treatment ,ANTIRHEUMATIC agents ,COST control ,COST effectiveness ,INCOME ,INFLAMMATORY bowel diseases ,IRIDOCYCLITIS ,LONGITUDINAL method ,MEDICAL appointments ,MEDICAL needs assessment ,PSORIASIS ,RHEUMATOLOGISTS ,SELF-evaluation ,SELF-management (Psychology) ,TELEMEDICINE ,TUMOR necrosis factors ,DISEASE management ,DISEASE relapse ,SYMPTOMS ,TREATMENT effectiveness ,SMARTPHONES ,DISEASE duration - Abstract
Objectives. Ankylosing spondylitis (AS) is a chronic disease that decreases mobility, function, and quality of life. This study introduced the "Smart-phone SpondyloArthritis Management System" (SpAMS), an interactive mobile health (mHealth) tool designed for AS/spondyloarthritis (SpA) disease management and used SpAMS data to evaluate clinical characteristics of Chinese patients with AS. Methods. SpAMS integrates patient's and physician's portals in a smart phone application. The Chinese Ankylosing Spondylitis Prospective Imaging Cohort was launched using SpAMS in April 2016. Patient self-assessments were completed online at baseline and at every subsequent clinic visit. Physician-reported assessments and treatments were recorded by rheumatologists during each visit. Results. In total, 1201 patients with AS [mean (SD) age, 30.6 (8.7) years; male, 82.6%] were recruited. Mean (SD) disease duration was 8.4 (6.1) years. Past or current symptoms of acute anterior uveitis (AAU), psoriasis, and inflammatory bowel disease (IBD) were observed in 21.0%, 3.7%, and 9.4% of patients, respectively. AAU and IBD occurred significantly more in patients with symptom duration > 10 years. The most commonly used medications at baseline were nonsteroidal anti-inflammatory drugs (98.2%). Patients using tumour necrosis factor inhibitors accounted for 20.8%, and 66.4% of patients used conventional synthetic disease-modifying antirheumatic drugs. At baseline, 57.2% of patients had inactive disease (ID)/low disease activity (LDA); this rate significantly improved to 79.2% after a mean follow-up of 13.3 (5.9) months. Compared with relapsed patients, new achievers of ID/LDA underwent more online patient assessments (P < .001). Problems solved in SpAMS caused 29.1% of clinic visits to a tertiary hospital unnecessary. SpAMS saved an average of 5.3 hours and 327.4 RMB per person on traffic expenses; these expenses equalled 16% of the Chinese monthly disposable personal income. Conclusions. SpAMS is a time- and cost-saving disease management tool that can help patients with AS perform self-management and provide valuable data to clinicians. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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