Digital app ‘really effective’ at improving mental health in rheumatoid arthritis
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A digital app was effective at improving mental health outcomes like anxiety and depression in a cohort of patients with rheumatoid arthritis, according to a speaker at EULAR 2024 Congress.
“One of the issues we are really concerned is about holistic care,” Mwidimi Ndosi, PhD, MSc, an associate professor in rheumatology nursing at the University of Bristol, told attendees during a press conference at the meeting. “We know there is strong evidence that patients with rheumatoid arthritis also have comorbid psychological distress like anxiety and depression.”
This distress often leads to poor quality of life in addition to disease activity, according to Ndosi, who was not involved with the study.
“We know that current medications are good at addressing disease activity but are not so good at addressing psychological distress,” he said.
In the current study, Gitta Jacob, PhD, head of clinical programs and R&D at GAIA AG, in Hamburg, Germany, and colleagues aimed to assess the efficacy and safety of the digital health app, which was developed by GAIA, in a cohort of 354 patients with RA.
“When we develop these interventions, we need to make sure they work,” Ndosi said. “This abstract was to evaluate the quality and effectiveness and safety of this app.”
There were 170 patients in an intervention group who received the digital health intervention in addition to their usual RA care. Outcomes in this group were compared with those for 184 patients who received only usual RA care.
The app included methods and exercises in a holistic approach to enhance mental quality of life, according to the researchers.
“This was a German study, but there are similar studies across different countries,” Ndosi said.
At 3 months, health-related quality of life — as assessed by the SF-36 mental component summary score — was greater in the intervention group compared with the usual care group, according to the researchers. For the intention-to-treat population, the SF-36 mental component summary score improved from 33.6 to 38.6 in the intervention group, compared with an increase from 34.2 to 35.7 in the usual care group.
The effect size of this outcome persisted through 6 months (d = 0.23), according to the findings.
“Those who received the digital health intervention really had good mental health in terms of quality of life as assessed by SF-36,” Ndosi said. “Those who received standard care really did not have any improvement in that regard.”
Secondary endpoint results showed an improvement in SF-36 fatigue of 33.8 to 27.67 in the intervention group, compared with an improvement from 31.1 to 30.7 (d = 0.21; P = .003) in the usual care group. This effect also persisted through 6 months follow-up.
Further findings at 3 months indicated that three mental health outcomes of interest — depression (d = 0.30; P < .001), anxiety (d = 0.23; P = .003) and social and work-related function (d = 0.06; P = .028) — all improved significantly.
“Those all improved in people who received the intervention,” Ndosi said.
There was no difference between the two groups in the SF-36 physical component score.
“The key message is that patients need both pharmacotherapeutic and non-pharmacotherapeutic interventions,” Ndosi said. “The conclusion is that this intervention was really effective at improving quality of life in terms of mental health in patients with rheumatoid arthritis.”
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Jacob G. OP0097-HPR. Presented at: EULAR 2024 Congress; June 12 to June 15, 2024, Vienna, Austria.
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