Digital Coaching Enhances Rheumatoid Arthritis Outcomes

Nov 20, 2017

This tool may be used to reduce stressors, improve well-being, and decrease symptoms.

Digital health coaching may serve as a useful tool for improving well-being and decreasing symptoms for patients with rheumatoid arthritis, according to new research presented at the 2017 ACR/ARHP Annual Meeting in San Diego.

Despite considerable advances in pharmacotherapy for patients with rheumatoid arthritis, the disease can still have a serious impact on a patient’s quality of life, the researchers noted. Promoting self-management of rheumatoid arthritis symptoms, including lifestyle changes, is essential to living well with the condition.

A study designed to examine the efficacy of a 12-week digital health coaching program for patients with rheumatoid arthritis, with personalized support from a dedicated health coach, was conducted by Pack Health, a digital health coaching company in Birmingham, Alabama.

The program’s goals include helping patients with rheumatoid arthritis reduce stressors related to their disease and make behavior changes, such as healthy eating and exercise, that are proven to reduce their symptoms and improve their well-being.

The study
The study consisted of 127 patients with rheumatoid arthritis who were enrolled in a 12-week digital health coaching program. Each patient was paired with a nonclinical health coach and contacted once a week by telephone. The conversations between patients and health coaches focused on the principles of patient engagement and activation toward behavior change.

Patients were surveyed about their behaviors and condition at baseline and then again after 12 weeks of coaching, including information about their mental and physical health using the PROMIS Global Health-10 survey and the Patient Activity Scale-II. Patients were also asked to self-report the number of flares they experienced each month.

The findings
The results showed significant improvements in patients’ overall well-being. These improvements included a decrease in body mass index (0.54kg/m2), an increase in weekly physical activity (73%), an increase in hours of sleep per night (0.4 hours), and decreases in consumption of alcohol and tobacco (15% and 25%, respectively).
Significant increases in the patients’ PROMIS Global Health-10 scores were also identified. This included a 24% increase in the survey’s physical health domain and a 17% increase in its mental health domain. The overall frequency of rheumatoid arthritis flares also dropped by 48% after program completion.

Implications for physicians
The findings suggest that rheumatoid arthritis symptom relief is associated with improvements in healthy behaviors and stressor reduction. When armed with the right information and tools, in addition to dedicated one-on-one support, patients were able to improve key health behaviors.
However, rheumatologists often lack the time, tools, and training needed to effectively coach patients during their limited office interactions, it was noted.

“This study shows that incorporating tools such as digital remote patient coaching into the workflow of clinicians can support better outcomes, patient experience, and health care utilization,” said Uma Srivastava, Associate Director of Strategic Partnerships at Pack Health, in a press release. “In turn, clinicians are able to overcome barriers such as time, cost, and patient non-adherence to recommended care.”

The authors concluded that future studies should examine the impact of digital coaching in various groups of patients with rheumatoid arthritis, such as underserved populations, those with multiple comorbidities, and patients with a new diagnosis versus those who have lived with rheumatoid arthritis for multiple years.

References:

American College of Rheumatology Press Release. “Digital Coaching Increases RA Patient Medicine Adherence and Health While Reducing Flares.” November 4, 2017.

Ghosh I, Uma Srivastava U, Burton BS, et al. “Assessing the Impact of a Digital Health Coaching Program for Patients with Rheumatoid Arthritis.” Paper Number 2257. 2017 ACR/ARHP Annual Meeting; San Diego, California.

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