Improving and Tracking Inflammatory Arthritis Outcomes With Personal Technology

Personal technology was becoming ubiquitous prior to the COVID-19 pandemic with the development of Fitbit, Apple watch, and other apps that track everything from calories to sleep. At Interdisciplinary Autoimmune Summit 2020, Alexis Ogdie, MD, MSCE, associate professor of medicine at the University of Pennsylvania, discussed the role personal tracking technology can play in assessing and managing patients with inflammatory arthritis. “Many of these personal technologies allow for better understanding of these multidisciplinary concepts in inflammatory arthritis,” she said.

According to Dr Ogdie, the use of personal technology can help physicians address some of the limitations of telehealth visits by, for example, allowing them to monitor blood pressure remotely. Connected health care is the concept of remote monitoring to track patients outcomes in between visits and can be done with personal technology.

For example, the Apple Heart Study showed a high positive predictive value for determining whether patients may develop atrial fibrillation. In the study, patients were monitored for signals that would suggest they might develop this condition and also whether they did develop it. “This study showed that you can use a device to monitor for outcomes,” she said.

In arthritis, there are several ways we can use personal technology to monitor domains of active disease, she said. One way is the use of automated hovering, which uses tech-based monitoring to track outcomes. Dr Odgie reviewed studies that showed patients with inflammatory arthritis who used the Arthritis Power app were able to track their outcomes and monitor their disease.

Remote monitoring can also help patients understand certain symptoms (eg, fatigue) better. Dr Ogdie explained how a study on sleep among patient with arthritis showed that patient-reported sleep and actigraphy were not correlated. She noted that this helped patients understand that their fatigue may not be connected to their arthritis. “This can also help us understand what is causing their fatigue and provide appropriate care,” she said.

Personal technologies can also be used to provide interventions to patients. For example, Fitbit with targets for physical activity showed improvements and continued improvements in fatigue compared with Fitbit alone and only patient education in one study, explained Dr Ogdie. “The way an intervention is delivered matters for how well it works,” she emphasized.

Dr Odgie also reviewed another study conducted in Europe that showed Fitbits were able to track and even identify patterns that helped predict flares. For example, if patients were resting more during the weekend, it suggested they were developing or had a flare.

There are several challenges for using these types of technologies, such as cost, set up of the device, poor battery life or quality, patient comfort level and adherence, the design of the device, data security, and user error. Also, the device can underestimate or overestimate outcomes, such as step count (eg, sitting in a rocking chair can be counted as steps).

“One of the exciting things about this point in time is we have so many new and easier to use technologies,” said Dr Ogdie. “The COVID-19 pandemic has taught us a lot about how to interact with patients virtually, and I am hoping our new normal will now include connected health,” she concluded.

For more coverage of IAS 2020, visit the newsroom.

—Melissa Weiss

Reference

Odgie A. Using personal technology to track and improve outcomes in inflammatory arthritis. Presented virtually at: Interdisciplinary Autoimmune Summit 2020; July 11, 2020.