Towards a more personalized approach of the ambulatory care for RA patients.

Background: Rheumatoid arthritis (RA) is a common, chronic inflammatory disease with a significant societal burden. The shift towards a 'treat to target' strategy has made ambulatory care for this condition more labor intensive and increased the importance of timely and personalized therapy adjustment. Patient-reported outcome measures (PROMs) carry the potential to improve understanding of disease remission and could be monitored via an integrated mobile health (mHealth) system to predict disease course and direct follow-up. Objectives: This project first aims to explore how patients with RA perceive the impact of their disease. Specifically, I will study the relationship between PROs and disease activity, to gain a better understanding of those situations where patients continue to experience disease impact despite well-controlled inflammation. Next, my research aims to explore what clinicians can do to mitigate this impact. First, I will address this by investigating if prognostic factors can be identified early in the course of RA that are associated with persistent disease impact. Second, I will study if mHealth applications are a feasible approach to explore the patient-reported impact of RA in more detail. Finally, this project will explore in practice if mHealth applications can improve patients’ self-efficacy, or confidence in their ability to self-manage the impact of their RA.

This PhD project will address the following research questions (RQ):
1) How does patient-reported disease impact relate to disease activity in RA, and can we mitigate persistent disease impact by leveraging prognostic factors in early disease?
2) Are mobile health applications a feasible approach to further explore the impact of RA by remotely monitoring PROs?
3) Can mobile health applications improve patients’ self-efficacy for managing RA and its impact, by providing multicomponent self-management support?