Session Title: Patient Outcomes, Preferences, and Attitudes Poster III
Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose: This study is to evaluate pattern shifts and outcome trends of treat-to-target (T2T) under standard of care in ankylosing spondylitis (AS) patients with interactive Smart System of Disease Management (SSDM).
Methods: Ankylosing Spondylitis Disease Activity Score (ASDAS) was adopted to evaluate the degree of disease activity and the inflammatory response in AS patients. ASDAS score ≤1.3 represents inactive disease (ID) status and achievement of T2T.
SSDM is a set of disease management tool based on mobile internet. The patient’s terminal system includes self-evaluation (ASDAS, HAQ), lab test results and medication management. After data entry, patients can synchronize data to the mobile terminal of their authorized rheumatologist. Under the guidance of health professionals, patients downloaded SSDM and registered, then self-evaluated ASDAS and was required for repeated evaluation after leaving the hospital. Data were analyzed and processed by IBM SPSS 22.0. The one-way ANOVA was used to analyze the influential factors. The chi square test was adopted to compare rates between groups, with P<0.05 as the criterion for the significant differences.
Results: From January 2015 to June 2017, 4,668 AS patients from 251 hospitals registered on SSDM, with mean age of 33.63 ± 11.47 years and median disease duration of 20.47 (0.73 – 66.73) months. Among them, 3,311 patients performed ASDAS evaluation at least once, totally 5,433 times; 989 patients carried out repeated evaluation for 2,122 times (male 690, female 299) through >5 month follow-up.
Among patients repeated assess ASDAS, baseline rate of T2T was 23% (228/989), and the final rate of T2T was significantly increased to 34% (334/989) (χ2 = 392.114, p <0.001) after median evaluation of 3 (2-16) times per patient. The mean score of ASDAS decreased from 2.13 ± 1.07 to 1.81 ± 1.07 (mean improvement -0.32 ± 0.58, p <0.001). Analysis of influential factors showed that: among T2T patients in baseline (228, 23%), 151/228 (66%) remained T2T and 77/228 (34%) relapsed at the end of follow-up, there was no difference in age, sex distribution and disease duration between maintaining T2T achiever and the relapser but the mean interval of ASDAS evaluation in maintaining T2T achiever was significantly shorter than that of the relapser (26 days vs. 40 days, p <0.05). Among patients failed to reach target in baseline (761/989, 77%), 183/761 (24%) patients achieved T2T and 578/761 (76%) patients remain failure of T2T. There were no significant difference in age, sex distribution and disease duration between T2T achievers and patients remaining failure of T2T, but the mean evaluation interval of the achievers was significantly shorter than that of the latter (30 days vs. 40 days, p <0.05).
Conclusion: T2T rate of AS in daily care is low in China. Significant improvement is observed under applying SSDM through empowering patients. Regularly performing self-management with SSDM associates with the achievements of maintaining T2T pattern and converting the patterns from failure of T2T to T2T. SSDM warrant a further evaluation and clinical application.
To cite this abstract in AMA style:Xue J, Fan W, Wei H, Yang J, Song H, Li H, Wang H, Duan X, Zhang Z, Huang J, Li Y, Ding J, Shi X, Zhang M, Wu Z, Mi C, Xiao F, Xiao H, Jia Y, Bai R, Bu Y, Wu H. Patterns and Outcomes on Disease Activity in Patients with Ankylosing Spondylitis (AS) Using Smart System of Disease Management (SSDM): Analysis of T2T Pattern Shift and Influential Factors [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/patterns-and-outcomes-on-disease-activity-in-patients-with-ankylosing-spondylitis-as-using-smart-system-of-disease-management-ssdm-analysis-of-t2t-pattern-shift-and-influential-factors/. Accessed November 15, 2019.
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