P113 Attitudes to Technology supported Rheumatoid Arthritis care Questionnaire study: Barriers to People with RA & their clinicians using Technology in the care pathway

Abstract

Abstract Background/Aims Rheumatoid arthritis (RA) outcomes have significantly improved with the treat-to-target paradigm, however, this necessitates intensive monitoring. Demand outstrips capacity in rheumatology services, making Mobile Health (mHealth) an attractive prospect. However, software developers often design without understanding the needs of ultimate users, solving non-existent problems. EULAR’s ‘Points to Consider’ for remote care specifies that interventions “should be developed in collaboration with all stakeholders including the healthcare team … and people with RMDs” as an overarching principle. This study sought to understand the barriers to end-users utilising technology within RA care. Methods Questionnaires were devised collaboratively between Rheumatologists and Computer scientists, informed by discussions with an RA patient group. Patients >18 with a diagnosis of RA completed paper surveys (utilising likert scales, ranking preferences, and tick-box answers) whilst awaiting appointments at Mile End Hospital (Barts Health NHS Trust). Clinicians were recruited to complete an online survey via mailing lists from multiple centres across London & South-East England, from October 2019-March 2020. The study was registered (CMPS ID [43816]). Ethical approval was obtained through the Bloomsbury Research and Ethics Committee (19/LO/1345). This work forms part of a larger mixed-methods study funded by the PAMBAYESIAN project grant. Results 109 people with RA returned paper questionnaires, 41 clinicians completed the online survey. Most used technology daily (87.2% patients; 100% clinicians), but few used RA apps (75.3% patients never used). Whilst clinician use was higher (54.8%), only 2/31 (6.4%) recommended Rheumatology apps to patients. People with RA were willing to share & record monitoring data, with only 8.3% unwilling to share via technology, 53.8% preferring monthly submissions. Clinical data, e.g. pain scores & joint counts, was preferred to sharing personal data. Sharing with clinicians was preferred to self-monitoring. 83.9% clinicians responded positively to using technology, but cited NHS technical capabilities, cost, need for clinical trials, and concerns for data saturation as the most significant barriers. Conclusion In spite of reasonable tech-literacy, willing to use, and many existing apps, people with RA and their clinicians do not utilise technology in RA care. Clinicians identified data saturation and insufficient evidence as barriers, in addition to systemic healthcare system barriers. Disclosure A. MacBrayne: None. H. Soyel: None. W. Marsh: None. N. Fenton: None. C. Pitzalis: None. P. Curzon: None. F. Humby: None.