DRAFT «ASPINE» MOBILE APPLICATION FOR PATIENTS WITH EARLY AXIAL SPONDYLOARTHRITIS

Telemedicine, including mobile applications for patients, is progressing rapidly now. However, patients with axial spondyloarthritis (axSpA) still have no applications that can be used to monitor their health status independently and to contact their physician remotely. Objective: to develop and test an «ASpine» mobile application for smartphones in real clinical practice. Material and methods. The draft «ASpine» mobile application has two parts: a mobile application for patient and a personal computer program used by a rheumatologist to monitor disease activity in patients. The patient part of «ASpine» consists in filling out the BASDAI and BASFI questionnaires and monitoring how recommendations for daily exercise therapy and medications are fulfilled. There is also an opportunity for constant contact with the physician through the mobile application. The patients from the Moscow cohort CoESAr (Cohort of Early SpondyloArthritis) which was made up at the V.A. Nasonova Research Institute of Rheumatology in 2013 and is being formed to the present time took part in mobile application testing. Results and discussion. The mean scores of BASDAI at inclusion and after 12-month follow-up were 3.3±1.7 and 2.1±1.7 (p > 0.5) and those of BASFI were 1.6±1.3 and 1.3±1.2, respectively (p > 0.5). To analyze the health status of 35 patients, one doctor requires 1 min daily if there are no reports of their worse health. It takes an average of 5–8 min to make a decision if the patient reports the occurrence of any symptom or an adverse reaction. The findings can lead to the conclusion that the «ASpine» mobile application allows patients to independently monitor disease activity, to store medical records, and to contact their physician remotely. Continuous monitoring of the patient's condition makes it possible to maintain low disease activity or remission for a long time.

1. Эрдес ШФ, Бадокин ВВ, Бочкова АГ и др. О терминологии спондилоартритов. Научно-практическая ревматология. 2015;53(6):657-60 [Erdes ShF, Badokin VV, Bochkova AG, et al. On the terminology of spondyloarthritis. Nauchno-Prakticheskaya Revmatologiya = Rheumatology Science and Practice. 2015;53(6):657-60 (In Russ.)]. doi: 10.14412/1995-4484-2015-657-660

2. Rudwaleit M, van der Heijde D, Landewe R, et al. The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part II): validation and final selection. Ann Rheum Dis. 2009;68:777-783. doi: 10.1136/ard.2009.108233

3. Smolen JS, Braun J, Dougados M, et al. Treating spondyloarthri-tis, including ankylosing spondylitis and psoriatic arthritis, to target: recommendations of an international task force. Ann Rheum Dis. 2014;73:6-16. doi: 10.1136/annrheumdis-2013-203419

4. Van der Heijde D, Ramiro S, Landewe R, et al. 2016 update of the ASAS-EULAR management recommendations for axial spondyloarthritis. Ann Rheum Dis. 2017;76:978-91. doi: 10.1136/annrheumdis-2016-210770

5. Румянцева ДГ, Дубинина ТВ, Демина АБ и др. Анкилозирующий спондилит и нерентгенологический аксиальный спондилоартрит: две стадии одной болезни? Терапевтический архив. 2017;89(5):33-7 [Rumyantseva DG, Dubinina TV, Demina AB, et al. Ankylosing spondylitis and non-radiological axial spondylitis: two stages of one disease? Terapevticheskii Arkhiv. 2017;89(5):33-7 (In Russ.)]. doi: 10.17116/terarkh201789533-37

6. Van den Berg R, de Hooge M, van Gaalen F, et al. Percentage of patients with spondyloarthritis in patients referred because of chronic back pain and performance of classification criteria: experience from the Spondyloarthritis Caught Early (SPACE) cohort. Rheumatology (Oxford). 2013;52:1492-9. doi: 10.1093/rheumatology/ket164

7. Molto A, Paternotte S, van der Heijde D, et al. Evaluation of the validity of the different arms of the ASAS set of criteria for axial spondyloarthritis and description of the different imaging abnormalities suggestive of spondyloarthritis: data from the DESIR cohort. Ann Rheum Dis. 2015;74:746-51. doi: 10.1136/annrheumdis-2013-204262

8. Rudwaleit M, Haibel H, Baraliakos X, et al. The early disease stage in axial spondylarthritis: results from the German Spondyloarthritis Inception Cohort. Arthritis Rheum. 2009 Mar;60(3):717-27. doi: 10.1002/art.24483

9. Kiltz U, Baraliakos X, Karakostas P, et al. Do patients with non-radiographic axial spondylarthritis differ from patients with AS? Arthritis Care Res (Hoboken). 2012 Sep;64(9):1415-22. doi: 10.1002/acr.21688

10. Roberts LJ, LaMont EG, Lim I, et al. Telerheumatology: an idea whose time has come. Int Med J. 2012; 42:1072-8. doi: 10.1111/j.1445-5994.2012.02931.x

11. Grainger R, Townsley H, White B, et al. Apps for people with rheumatoid arthritis to monitor their disease activity: A review of apps for best practice and quality. JMIR mHealth uHealth. 2017 Feb 21;5(2):e7. doi: 10.2196/mhealth.6956

12. Kay M, Santos J, Takane M. mHealth: New horizons for health through mobile technologies. World Health Organization. 2011;3:66-71.

13. Becker S, Miron-Shatz T, Schumacheret N, al. mHealth 2.0: experiences, possibilities, and perspectives. JMIR mHealth uHealth. 2014;2(2):e24. doi: 10.2196/mhealth.3328

14. Tani C, Trieste L, Lorenzoni V, et al. Health information technologies in systemic lupus erythematosus: focus on patient assessment. Clin Exp Rheumatol. 2016;34(5):54.

15. Scheibe MM, Imboden JB, Schmajuk G, et al. Efficiency gains for rheumatology consultation using a novel electronic referral system in a safety-net health setting. Arthritis Care Res. 2015;67(8):1158-63. doi: 10.1002/acr.22559

16. Azevedo R, Bernardes M, Fonseca J, et al. Smartphone application for rheumatoid arthritis self-management: cross-sectional study revealed the usefulness, willingness to use and patients' needs. Rheumatol Int. 2015;35(10):1675-85. doi: 10.1007/s00296-015-3270-9

17. Nishiguchi S, Ito H, Yamada M, et al. Self-assessment tool of disease activity of rheumatoid arthritis by using a smartphone application. Telemed J E Health. 2014 Mar;20(3):235-40. doi: 10.1089/tmj.2013.0162

18. Эрдес ШФ, Дубинина ТВ, Румянцева ОА и др. Эволюция аксиального спондилоартрита за 12 месяцев наблюдения когорты КоРСаР. Научно-практическая ревматология. 2016;54(Прил 1):55-9 [Erdes ShF, Dubinina TV, Rumyantseva OA, et al. The evolution of axial spondyloarthritis during 12-month follow-up study of a CoRSaR cohort. Nauchno-Prakticheskaya Revmatologiya = Rheumatology Science and Practice. 2016;54(Suppl. 1):55-9

19. In Russ.)]. doi: 10.14412/1995-4484-2016-1S-55-59

20. Sieper J, Rudwaleit M, Baraliakos X, et al. The Assessment of SpondyloArthritis international Society (ASAS) handbook: a guide to assess spondyloarthritis. Ann Rheum Dis. 2009;68(2):ii1-ii44. doi: 10.1136/ard.2008.104018

21. Catarinella F, Bos W. Digital health assessment in rheumatology: current and future possibilities. Clin Exp Rheumatol. 2016;34(101):2-4.

22. Smolen JS, Schö ls M, Braun J, et al. Treating axial spondyloarthritis and peripheral spondyloarthritis, especially psoriatic arthritis, to target: 2017 update of recommendations by an international task force. Ann Rheum Dis. Pub Online First: 06 July 2017. doi: 10.1136/annrheumdis-2017-211734