Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


Feasibility of Online Registration of Physical Functioning by RA Patients in the Out Patient Clinic.

Koevoets3,  Rosanne, de Glas3,  N. A., Speyer1,  I., Schouffour3,  A. A., Huizinga3,  T. W. J., Vlieland2,  Thea P. M. Vliet, Allaart2,  Cornelia F.

Bronovo Hospital, The Hague
Leiden University Medical Centre, Leiden, The Netherlands
Leiden University Medical Centre, Leiden, The Netherlands

Background:

Monitoring functional ability is important to assess efficacy of treatment in rheumatoid arthritis (RA), however implementation of routine assessment of functional ability in daily practice remains difficult.

Purpose:

To assess the feasibility of and patients' opinion about autonomic online health assessment questionnaire (HAQ) registrations by RA patients in our out patient clinic

Methods:

RA patients visiting the out patient department were given an oral instruction and asked to fill in a computerized HAQ in METEOR, a free web based program designed for monitoring both functional ability and disease activity. The time needed to fill in the HAQ and any problems arising were registered. Next, patients answered questions on computer access, the usefulness of the HAQ and the METEOR program. Answers were filled in on a 5 point Likert scale with a high score representing a positive answer and a low score a negative one.

Results:

Of 111 consecutive patients, 92 agreed to participate, and 78 patients completed the whole evaluation, while 14 patients stopped early because of time constraints. Seventy-seven percent of the participants were female, and the average age was 58.4 years (range 25–78). Mean (SD) disease duration was 10.4 (8.7) years and mean (SD) HAQ score at the time of assessment was 1.01 (0.72). Of all participants, 84% had personal computer access and 73% reported frequent (daily or weekly) computer use. The mean time patients needed to fill in their own HAQ was 6 minutes, which 99% of patients reported as reasonable or good. Patients felt they had not needed much assistance when filling in the HAQ, although the investigator had noted that some assistance (mainly concerning technical computer problems) was needed in 78% of all patients. Average scores on questionnaire items are presented in table 1. Ninety-five percent of patients said they would be willing to fill in the computerized HAQ at the next visit and 83% was prepared to come to the hospital earlier to fill in the HAQ there, 73% of patients would like the option of filling in the HAQ at home. Twenty percent of patients felt there were missing subjects in the HAQ, in particular work-related activities, social activities and sports, as well as registration of fatigue and psychological problems. Ninety-four percent reported that the subjects included in the HAQ were all relevant. According to patients discussing problems in daily functioning is important, however it is not always part of the out patients visit to the rheumatologist (table1).

Table 1. Results of patients survey questions.

 MeanSd
1. What was your opinion about filling in the HAQ on the computer? (1=very difficult 5=very easy)4.51.1
2. Would you be capable of filling in the HAQ independently the next visit? (1=definitely not 5=definitely)4.21.3
3. Did you appreciate filling in the HAQ on the computer in the waiting room? (1=no, not at all 5=yes, very much)4.01.2
4. How important is it discuss about problems in daily functioning with you rheumatologist? (1=not important at all 5=very important)4.01.1
5. How often are problems in daily functioning discussed with the rheumatologist? (1=never 5=always)3.51.3
6. Do the questions in the HAQ give an accurate representation of your abilities and limitations in daily functioning? (1=not at all 5=very much)3.91.2

Conclusion:

Independent computerized registration of physical functioning by RA patients in the out patient clinic is feasible and is appreciated by patients. Filling in the HAQ using the METEOR tool before seeing the rheumatologist may stimulate to discuss functional (dis)ability during the consultation, which patients find important, but is not always done.

To cite this abstract, please use the following information:
Koevoets, Rosanne, de Glas, N. A., Speyer, I., Schouffour, A. A., Huizinga, T. W. J., Vlieland, Thea P. M. Vliet, et al; Feasibility of Online Registration of Physical Functioning by RA Patients in the Out Patient Clinic. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :1755
DOI: 10.1002/art.29520

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