Project ID NS-MH2023_41


Co Supervisor 1A IoPPN/PsychologyWebsite

Co Supervisor 1B FoLSM/Department of Inflammation BiologyWebsite

Remote assessment of disease flares in rheumatoid arthritis

There has been an increasing interest in the potential of remote assessment technologies in healthcare settings (e.g., electronic patient reported outcomes [ePROs]) to allow additional information to inform decision making. Until the Covid-19 pandemic these technologies were not routinely used in rheumatology settings. The pandemic led to a step change in care delivery with fewer in-person appointments and a shift towards patient-initiated (e.g., due to disease flare) rather than routine appointments. As a result, remote assessment is increasingly important and often embedded within routine care, typically as ePROs completed every few months. There is a potential need for increased monitoring around key points in the disease course (e.g. treatment initiation, during disease flare).

This project will examine the use of daily ePROs and wearables during rheumatoid arthritis disease flare. Specifically, to evaluate the ability of remote assessment technologies to identify disease flares, characterise flare types (inflammatory/non-inflammatory), and evaluate the precipitating factors for and course of flares.

This studentship will consist of four studies:

Systematic review of remote assessment technologies for monitoring disease flare in rheumatological conditions (0-9months)

Analysis of existing routinely collected ePRO data to identify the frequency of and precipitating factors for disease flare (3-12months)

Pilot mixed-methods measurement burst study with 10 high-risk patients completing weekly assessments for 10 weeks, with daily assessments for 10 days during flare (9-18months)

Measurement burst study with ~100 high-risk patients completing weekly assessments for 6 months, with daily assessments for 10 days during flare (18-36months)

One representative publication from each co-supervisor:

Tung, H. Y., Galloway, J., Matcham, F., Hotopf, M., & Norton, S. (2021). High-frequency follow-up studies in musculoskeletal disorders: a scoping review. Rheumatology, 60(1), 48-59.

Bechman, K., Sin, F. E., Ibrahim, F., Norton, S., Matcham, F., Scott, D. L., Cope, A., & Galloway, J. (2018). Mental health, fatigue and function are associated with increased risk of disease flare following TNF inhibitor tapering in patients with rheumatoid arthritis: an exploratory analysis of data from the Optimizing TNF Tapering in RA (OPTTIRA) trial. RMD open, 4(1), e000676.