Effect of digital monitoring and counselling on self-management ability in patients with rheumatoid arthritis: a randomised controlled trial

Rheumatology (Oxford). 2025 Jan 1;64(1):310-320. doi: 10.1093/rheumatology/kead709.

Abstract

Objectives: To assess a remote physiotherapist (PT) counselling intervention using self-monitoring tools for improving self-management ability, physical activity participation and health outcomes in people with rheumatoid arthritis (RA).

Methods: Eligible participants were randomly assigned to receive group education, a Fitbit®, a self-monitoring app, and PT counselling phone calls (Immediate Group). The Delayed Group received a monthly e-newsletter until week 26, and then the intervention. The primary outcome was Patient Activation Measure (PAM-13). Participants were assessed at baseline, 27 weeks (the primary end point) and 53 weeks. Secondary outcomes included disease activity, pain, fatigue, depression, sitting/walking habits, daily physical activity time and daily awake sedentary time. Generalized Linear Mixed-effect Models (GLMMs) were used to assess the effect of the intervention on the change of each outcome measure from the initiation to 27 weeks after the intervention.

Results: Analysis included 131 participants (91.6% women; 80.2% completed during the COVID-19 pandemic). The mean change of PAM-13 at 27 weeks was 4.6 (Standard Deviation [SD] = 14.7) in the Immediate Group vs -1.6 (SD = 12.5) in the Delayed Group. The mean change in Delayed Group at 53 weeks (after the 26-week intervention) was 3.6 (SD = 14.6). Overall, the intervention improved PAM-13 at 27 weeks post-intervention from the GLMM analysis (adjusted coefficient: 5.3; 95% CI: 2.0, 8.7; P ≤ 0.001). Favourable intervention effects were also found in disease activity, fatigue, depression and self-reported walking habit.

Conclusion: Remote counselling paired with self-monitoring tools improved self-management ability in people with RA. Findings of secondary outcomes indicate that the intervention had a positive effect on symptom management.

Keywords: e-health; patient activation; physical activity; rheumatoid arthritis; self-management; self-monitoring.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Arthritis, Rheumatoid* / psychology
  • Arthritis, Rheumatoid* / rehabilitation
  • Arthritis, Rheumatoid* / therapy
  • COVID-19*
  • Counseling* / methods
  • Exercise
  • Female
  • Humans
  • Male
  • Middle Aged
  • SARS-CoV-2
  • Self-Management* / methods