Evaluation of a web-based self-monitoring application (MyRA) to empower people with rheumatoid arthritis in daily life.

Abstract

To evaluate MyRA, a web-based self-monitoring application for RA, on patient empowerment, usability and perceived usefulness. MyRA was co-developed with patients and used at their own discretion during a 4-month prospective study with patient questionnaires at T0 (baseline), T1 (2 months) and T2 (4 months). The primary outcome was patient empowerment (Patient Activation Measure-13; 0-100). Secondary outcomes included frequency of use, usability (System Usability Scale; 0-100) and perceived usefulness (study specific questions). Descriptive statistics and repeated measures ANOVA were applied with post-hoc subgroup analysis based on frequency of use [subgroup A (infrequent users): 1-7 times; subgroup B (frequent users): ≥8 times]. Among 548 registered patients [90.1% female, mean age 51.8 (s.d. 11.9) years, mean disease duration 10.2 (s.d. 10.1) years], 54 patients never used the application (9.9%), 405 patients were infrequent users (73.9%) and 89 patients were frequent users (16.2%). In the total user group, no statistical difference was found for patient empowerment after 4 months (T0: 55.8, T2: 54.4, P = 0.09). However, subgroup B showed a statistically significant, though not clinically meaningful, decrease (T0: 56.2, T2 53.6, P = 0.04). Subgroup B reported higher usability scores compared with subgroup A (75.9 vs 62.9, P < 0.001) and was more outspoken in perceived usefulness. Despite major patient involvement throughout development, self-monitoring via MyRA did not increase patient empowerment. The study had a considerable decline in application engagement over time, with only a small subgroup of frequent users. These users showed more positive attitudes regarding usability and perceived usefulness of MyRA.