Phone app to transform outpatient consultations through regular symptom tracking

People with rheumatoid arthritis will be able to monitor and record their pain and other symptoms between hospital appointments, thanks to a new phone app linking to electronic patient records.

It will be the focus of a £2.1m research study which aims to improve outpatient consultations by making sure both health staff and patients have detailed information on how patients have felt in the weeks and months between appointments.

It’s led by Professor Will Dixon, Director of the Centre for Epidemiology Versus Arthritis at The University of Manchester and an honorary consultant rheumatologist at Salford Royal NHS Foundation Trust, part of the Northern Care Alliance NHS Group, and by Dr Sabine van der Veer, Senior Lecturer in Health Data Science at the university. It is funded by the National Institute for Health Research (NIHR) in partnership with the charity Versus Arthritis.

By recording ongoing symptoms in a phone app which links to electronic health records, the Remote Monitoring of Rheumatoid Arthritis (REMORA) study team will be able to identify distinct patterns of symptoms and the rhythm of long-term conditions over time. This could help to identify links between symptoms such as pain and fatigue, as well as helping to understand more clearly how well people respond to new treatments.

Discussion

Professor Dixon said: “Rheumatoid arthritis (RA) is a common long-term condition that causes painful, swollen joints and disability. To plan treatment, hospital specialists ask people how their symptoms have been since their last appointment. But this last appointment often happened months ago, so people may not remember the details. Good treatment planning is hard without this information, increasing people’s chances of continued pain, inability to work, needing surgery and dying earlier.

“To solve this, we have developed a symptom tracking system. It enables patients to track their symptoms daily using a smartphone app, which sends the results to their electronic patient record for discussion at their next hospital appointment.

“Our previous research has shown that patients like the system, so now we want to explore what effect it has on the care and health of people with RA.

“It’s also crucial that we support all patients to use the system, irrespective of age, background, familiarity with technology or health.”

The study, which starts in September 2021, will be hosted at Salford Royal and will involve 12 RA outpatient clinics in England.

Patients

Professor Dixon added: “We have worked closely with a diverse group of patients and specialists to design the system. Going forward, 10 people with RA will continue to work with us to help develop patient materials, understand what we find and help communicate this to other researchers, patients and national RA organisations.”

Karen Staniland is one of the patients who has been involved in advising on the study. She has had RA for 11 years and suffers intermittent flares with tender and swollen joints. She said: “I found the app quite straightforward to use and it was really interesting to see the graphs of my symptoms when I went for a clinic appointment. It gave me an insight into how easy it was to forget any pain you’ve had when you’re feeling better, so the specialist would have missed my flares without the app.   It also gave me the opportunity to identify if I had been involved in any specific activities which might have increased my pain onset, so it has already helped me, and I have great hopes for the future.”