title: Toward Electronic Health Recording: Evaluation of Electronic Patient-reported Outcome Measures System for Remote Monitoring of Early Rheumatoid Arthritis.
abstract: To assess the use of electronic patient-reported outcome measures (ePROM) in standard clinical practice for early rheumatoid arthritis (RA) management, the ePROM ability to enhance clinical care, and how computing technology can improve the patients' adherence to therapy.
  
  
  
  In a double-blinded randomized-controlled study, 211 patients with early RA diagnosed according to American College of Rheumatology/European League Against Rheumatism criteria completed a PROM in paper format at their first clinic visit. Patients were then randomized to Group 1, which completed an ePROM questionnaire monthly, or Group 2, which continued the standard paper PROM format. Over a 12-month period, Group 1 patients were assessed every 3 months in the clinic, whereas Group 2 patients were assessed in the clinic initially monthly for 6 months, then every 3 months. The primary endpoint was the equivalence of outcomes [Routine Assessment of Patient Index Data 3 (RAPID-3) and 28-joint Disease Activity Score (DAS28)] in both groups. The secondary endpoint was the patients' adherence to their medications.
  
  
  
  There was no significant difference between disease activity measures as well as DAS28 and RAPID-3 scores at 3, 6, and 12 months of management, although there was a trend toward lower patient-reported tender joint count and functional disability score in the active group versus the control group. The patients' adherence to antirheumatic therapy was significantly higher (p < 0.01) in the ePROM group, whereas stopping disease-modifying antirheumatic drugs for intolerability was significantly higher (p < 0.01) in the control group at 12 months of treatment.
  
  
  
  We found ePROM equivalent to standard paper PROM format. Further, it enabled the patients to personally monitor how they are doing regarding their disease activity and helped to optimize their adherence to their treatment.
authors.affiliation: From King's College, London, UK; Rheumatology and Rehabilitation, and Community and Public Health, Ain Shams University, Cairo, Egypt; Rheumatology Department, King Abdel Aziz University, Jeddah, Saudi Arabia; Rheumatology and Rehabilitation, Tanta University, Tanta; Internal Medicine, Cairo University, Egypt; Rheumatology, North Middlesex University Hospitals, London, UK. drelmiedany@rheumatology4u.com.|Y. El Miedany, MD, FRCP, Honorary senior clinical lecturer, King's College; M. El Gaafary, MD, Community and Public Health, Ain Shams University; S. Youssef, MD, Rheumatology and Rehabilitation, Ain Shams University; S. Bahlas, MD, Rheumatology Department, King Abdel Aziz University; S. Almedany, MD, Rheumatology and Rehabilitation, Tanta University; I. Ahmed, MRCP, Internal Medicine, Cairo University; D. Palmer, Dip Rheum Nursing, Rheumatology, North Middlesex University Hospitals. drelmiedany@rheumatology4u.com.
authors.forename: Yasser
authors.initials: Y
authors.lastname: El Miedany
authors.affiliation: From King's College, London, UK; Rheumatology and Rehabilitation, and Community and Public Health, Ain Shams University, Cairo, Egypt; Rheumatology Department, King Abdel Aziz University, Jeddah, Saudi Arabia; Rheumatology and Rehabilitation, Tanta University, Tanta; Internal Medicine, Cairo University, Egypt; Rheumatology, North Middlesex University Hospitals, London, UK.|Y. El Miedany, MD, FRCP, Honorary senior clinical lecturer, King's College; M. El Gaafary, MD, Community and Public Health, Ain Shams University; S. Youssef, MD, Rheumatology and Rehabilitation, Ain Shams University; S. Bahlas, MD, Rheumatology Department, King Abdel Aziz University; S. Almedany, MD, Rheumatology and Rehabilitation, Tanta University; I. Ahmed, MRCP, Internal Medicine, Cairo University; D. Palmer, Dip Rheum Nursing, Rheumatology, North Middlesex University Hospitals.
authors.forename: Maha
authors.initials: M
authors.lastname: El Gaafary
authors.affiliation: From King's College, London, UK; Rheumatology and Rehabilitation, and Community and Public Health, Ain Shams University, Cairo, Egypt; Rheumatology Department, King Abdel Aziz University, Jeddah, Saudi Arabia; Rheumatology and Rehabilitation, Tanta University, Tanta; Internal Medicine, Cairo University, Egypt; Rheumatology, North Middlesex University Hospitals, London, UK.|Y. El Miedany, MD, FRCP, Honorary senior clinical lecturer, King's College; M. El Gaafary, MD, Community and Public Health, Ain Shams University; S. Youssef, MD, Rheumatology and Rehabilitation, Ain Shams University; S. Bahlas, MD, Rheumatology Department, King Abdel Aziz University; S. Almedany, MD, Rheumatology and Rehabilitation, Tanta University; I. Ahmed, MRCP, Internal Medicine, Cairo University; D. Palmer, Dip Rheum Nursing, Rheumatology, North Middlesex University Hospitals.
authors.forename: Sally
authors.initials: S
authors.lastname: Youssef
authors.affiliation: From King's College, London, UK; Rheumatology and Rehabilitation, and Community and Public Health, Ain Shams University, Cairo, Egypt; Rheumatology Department, King Abdel Aziz University, Jeddah, Saudi Arabia; Rheumatology and Rehabilitation, Tanta University, Tanta; Internal Medicine, Cairo University, Egypt; Rheumatology, North Middlesex University Hospitals, London, UK.|Y. El Miedany, MD, FRCP, Honorary senior clinical lecturer, King's College; M. El Gaafary, MD, Community and Public Health, Ain Shams University; S. Youssef, MD, Rheumatology and Rehabilitation, Ain Shams University; S. Bahlas, MD, Rheumatology Department, King Abdel Aziz University; S. Almedany, MD, Rheumatology and Rehabilitation, Tanta University; I. Ahmed, MRCP, Internal Medicine, Cairo University; D. Palmer, Dip Rheum Nursing, Rheumatology, North Middlesex University Hospitals.
authors.forename: Sami
authors.initials: S
authors.lastname: Bahlas
authors.affiliation: From King's College, London, UK; Rheumatology and Rehabilitation, and Community and Public Health, Ain Shams University, Cairo, Egypt; Rheumatology Department, King Abdel Aziz University, Jeddah, Saudi Arabia; Rheumatology and Rehabilitation, Tanta University, Tanta; Internal Medicine, Cairo University, Egypt; Rheumatology, North Middlesex University Hospitals, London, UK.|Y. El Miedany, MD, FRCP, Honorary senior clinical lecturer, King's College; M. El Gaafary, MD, Community and Public Health, Ain Shams University; S. Youssef, MD, Rheumatology and Rehabilitation, Ain Shams University; S. Bahlas, MD, Rheumatology Department, King Abdel Aziz University; S. Almedany, MD, Rheumatology and Rehabilitation, Tanta University; I. Ahmed, MRCP, Internal Medicine, Cairo University; D. Palmer, Dip Rheum Nursing, Rheumatology, North Middlesex University Hospitals.
authors.forename: Samah
authors.initials: S
authors.lastname: Almedany
authors.affiliation: From King's College, London, UK; Rheumatology and Rehabilitation, and Community and Public Health, Ain Shams University, Cairo, Egypt; Rheumatology Department, King Abdel Aziz University, Jeddah, Saudi Arabia; Rheumatology and Rehabilitation, Tanta University, Tanta; Internal Medicine, Cairo University, Egypt; Rheumatology, North Middlesex University Hospitals, London, UK.|Y. El Miedany, MD, FRCP, Honorary senior clinical lecturer, King's College; M. El Gaafary, MD, Community and Public Health, Ain Shams University; S. Youssef, MD, Rheumatology and Rehabilitation, Ain Shams University; S. Bahlas, MD, Rheumatology Department, King Abdel Aziz University; S. Almedany, MD, Rheumatology and Rehabilitation, Tanta University; I. Ahmed, MRCP, Internal Medicine, Cairo University; D. Palmer, Dip Rheum Nursing, Rheumatology, North Middlesex University Hospitals.
authors.forename: Ihab
authors.initials: I
authors.lastname: Ahmed
authors.affiliation: From King's College, London, UK; Rheumatology and Rehabilitation, and Community and Public Health, Ain Shams University, Cairo, Egypt; Rheumatology Department, King Abdel Aziz University, Jeddah, Saudi Arabia; Rheumatology and Rehabilitation, Tanta University, Tanta; Internal Medicine, Cairo University, Egypt; Rheumatology, North Middlesex University Hospitals, London, UK.|Y. El Miedany, MD, FRCP, Honorary senior clinical lecturer, King's College; M. El Gaafary, MD, Community and Public Health, Ain Shams University; S. Youssef, MD, Rheumatology and Rehabilitation, Ain Shams University; S. Bahlas, MD, Rheumatology Department, King Abdel Aziz University; S. Almedany, MD, Rheumatology and Rehabilitation, Tanta University; I. Ahmed, MRCP, Internal Medicine, Cairo University; D. Palmer, Dip Rheum Nursing, Rheumatology, North Middlesex University Hospitals.
authors.forename: Deborah
authors.initials: D
authors.lastname: Palmer
mesh_terms: D000328:Adult; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D019468:Disease Management; D004311:Double-Blind Method; D057286:Electronic Health Records; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D000071066:Patient Reported Outcome Measures; D012074:Remission Induction; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents
keywords: ADHERENCE; EARLY ARTHRITIS; ELECTRONIC MEDICAL RECORDS; PATIENT-REPORTED OUTCOME MEASURES