Background/Purpose: Traditional management of rheumatoid arthritis (RA) is by rheumatologist review 3 to 6 monthly. This is not sustainable in many healthcare systems as demand exceeds rheumatologist capacity, with these demands projected to increase. Mobile software (an application or app) could enable patients to provide remote monitoring of health status via patient reported outcomes (PROs), patient-performed joint counts and electronic messages to health care professionals (HCP). This worked aimed to 1. Assess opinions of people with RA and HCP regarding design and functionality of an app and acceptability and usefulness of an app assisted telehealth approach for RA 2. Develop an app and 3. Assess usability of the app.

Methods: Semi-structured interviews were undertaken with people with RA (ACR 2010 criteria) and HCP, recruited from a hospital rheumatology service. Interviews explored technology use, app functionality, barriers and facilitators to app use and potential impacts of app implementation on service provision and experience. Thematic analysis was performed and recruitment concluded when saturation achieved. An app (RAConnect) was developed in iOS and android with design and function informed by interview data. People with RA used RAConnect on their mobile devices for one month then usability was assessed (System usability scale) and free text feedback collected.

Results: Nine people with RA (27-79yrs, 7 females, 1-26yrs of RA, low-moderate disease activity) and 11 HCP were interviewed. Four themes were identified 1. Variable app readiness. 2. Reduced barriers with high app usability and text message communication. 3. Pros and cons of PROs, with some ambivalence 4. Resource allocation and engagement – PRO reporting via an App is acceptable to guide HCP in allocation of limited resource while also increasing patient engagement. Usability testing with 16 people with RA confirmed RAConnect had high usability (SUS 80/100, 90^th centile). Both the app and a telehealth approach had high acceptability. “I think a wraparound thing like RAConnect would allow better spacing between appointments and for me it would make them less stressful.”48Male “I think that it has the potential to be very useful in managing my RA. It is easy to use and may mean less visits to the rheumatologist.” 49Male. “It’ll be a great tool for both the Doctors, their clinical staff and their patients.” 70Female.

Conclusion: A patient-held app for RA monitoring and communication with rheumatology care provider will be acceptable and desirable for many patients. Further research is required to develop multi-media material to train people with RA to perform joint counts and to validate patient-performed joint counts. During implementation assessment of the patient experience of using this telehealth system, disease outcomes, costs and impact on workflow of HCP will be required.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/patient-clinician-co-participation-in-design-of-an-app-for-ra-management-via-telehealth-yields-an-app-with-high-usability-and-acceptance/