Improvement of Disease Management and Cost Effectiveness in Chinese Patients with Ankylosing Spondylitis Using a Smart-Phone Management System: A Prospective Cohort Study

Abstract EN

Objectives.

Ankylosing spondylitis (AS) is a chronic disease that decreases mobility, function, and quality of life.

This study introduced the “Smart-phone SpondyloArthritis Management System” (SpAMS), an interactive mobile health (mHealth) tool designed for AS/spondyloarthritis (SpA) disease management and used SpAMS data to evaluate clinical characteristics of Chinese patients with AS.

Methods.

SpAMS integrates patient’s and physician’s portals in a smart phone application.

The Chinese Ankylosing Spondylitis Prospective Imaging Cohort was launched using SpAMS in April 2016.

Patient self-assessments were completed online at baseline and at every subsequent clinic visit.

Physician-reported assessments and treatments were recorded by rheumatologists during each visit.

Results.

In total, 1201 patients with AS [mean (SD) age, 30.6 (8.7) years; male, 82.6%] were recruited.

Mean (SD) disease duration was 8.4 (6.1) years.

Past or current symptoms of acute anterior uveitis (AAU), psoriasis, and inflammatory bowel disease (IBD) were observed in 21.0%, 3.7%, and 9.4% of patients, respectively.

AAU and IBD occurred significantly more in patients with symptom duration > 10 years.

The most commonly used medications at baseline were nonsteroidal anti-inflammatory drugs (98.2%).

Patients using tumour necrosis factor inhibitors accounted for 20.8%, and 66.4% of patients used conventional synthetic disease-modifying antirheumatic drugs.

At baseline, 57.2% of patients had inactive disease (ID)/low disease activity (LDA); this rate significantly improved to 79.2% after a mean follow-up of 13.3 (5.9) months.

Compared with relapsed patients, new achievers of ID/LDA underwent more online patient assessments (P < .001).

Problems solved in SpAMS caused 29.1% of clinic visits to a tertiary hospital unnecessary.

SpAMS saved an average of 5.3 hours and 327.4 RMB per person on traffic expenses; these expenses equalled 16% of the Chinese monthly disposable personal income.

Conclusions.

SpAMS is a time- and cost-saving disease management tool that can help patients with AS perform self-management and provide valuable data to clinicians.