Background/Purpose: Rheumatoid arthritis (RA) is the most common autoimmune inflammatory arthritis in adults. RA has a significant negative impact on the ability to perform daily activities, including work and household tasks as well as health-related quality of life. Improving patients’ quality of life by reducing symptoms and reducing functional limitations are some of the goals of RA treatment. This prospective study (n=314) examines the impact of a digital health coaching intervention on an RA population measured by quality-adjusted life years (QALY) as well as symptom severity and disease activity. One QALY equates to one year spent in perfect health and the PROs measure individual aspects of overall RA health.

Methods: RA patients (n=314) were recruited from sources such as the ACR RISE registry, clinical referral, consented, and enrolled in a 12-week digital health coaching behavior modification program with data collection at baseline and upon completion in the program. Information about mental and physical health was collected through Patient-Reported Outcomes Measurement Information System (PROMIS) Global Health-10. Using a formula developed by Revicki et al.1 and patient responses to the PROMIS Global-10 assessment, a calculation on the number of added QALYs was made for patients receiving the intervention. In addition to PROMIS, the CASE Adherence Index was used to measure medication adherence and patients reported the number of flares they experienced the previous month before and after the intervention.  

Results: Results indicate significant improvements in average PROMIS Mental Health score (pre = 42.2 vs post = 48.3, p< 0.001) and PROMIS Physical Health Score (pre = 37.4 vs post = 41.5, p< 0.001) for RA patients with a result of 1.8 QALY.  In addition, the average number of flares  dropped by 50% (pre = 6.6 vs post = 3.3) and medication adherence improved by 11% (pre = 69% vs post = 80%).

Conclusion: The results of the study indicate that digital health coaching improves healthy behaviors, overall quality of life and decrease RA symptoms. Future studies should examine the impact of coaching in various segments of RA patients such as underserved, those with multiple comorbidities and those newly diagnosed versus patients living with RA for multiple years.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/assessing-the-impact-of-digital-health-coaching-on-quality-adjusted-life-years-symptom-severity-and-disease-activity-in-patients-with-rheumatoid-arthritis/