Innovative app boosts mental health in patients with RA

The digital health app RECLARIT significantly improved the mental aspects of quality-of-life for patients with rheumatoid arthritis (RA). The use of the app effectively reduced symptoms of depression and fatigue, although it had no impact on pain or physical function.

Effective DMARD treatment controls disease activity, but psychosocial stress such as depression and fatigue often impacts a patient´s life despite low disease activity [1,2]. “Some of the psychological stress aspects of the disease are still there despite DMARD therapy properly controlling the inflammation, and for those patients, we try to offer a digital intervention tool to optimise their mental health,” explained Prof. Frank Behrens (Goethe-University & Fraunhofer ITMP, Germany) [1].

RECLARIT is an internet-based health app designed for people with RA. The app provides methods and exercises –often relying on cognitive-behavioural therapy– and follows a holistic approach to support patients in enhancing their psychological quality-of-life. To evaluate the app’s effectiveness, Prof. Behrens and colleagues conducted a 2-armed randomised-controlled trial including 354 adult patients with RA assigned to use RECLARIT in addition to standard-of-care or standard-of-care alone.

The primary endpoint was the change in health-related quality-of-life (HRQoL) from baseline to month 3, as measured by the SF-36 Mental Component Summary (MCS) score. Secondary endpoints included depression, anxiety, fatigue, social work-related functioning, pain, physical function, and safety. The participants had longstanding RA, and about 50% were treated with biologics or a JAK inhibitor. “Unfortunately, no proper disease activity measurements were available in this study,” Prof. Behrens said.

At 3 months, SF-36 MCS was significantly higher in those using the app versus standard-of-care alone (38.6 vs 35.7; P=0.014), and this effect was maintained at 6 months (39.4 vs 36.4; P=0.02; see Figure). Moreover, both fatigue and depression significantly improved with the use of the digital health app. No difference was observed in pain or physical function. “This is more an area where we would expect to see effects with our pharmacological therapy,” Prof. Behrens commented.

Figure: Psychological health-related quality-of-life improved significantly over 6 months in patients using the app [3]



SF-36 MCS, Mental Component Summary 36.

The app can serve as a scalable and easily accessible option to reduce patients’ psychological distress by providing them with disease management and coping strategies. “We believe that adding this application to proper DMARD therapy might have some positive impact on the mental health of our patients,” Prof. Behrens concluded.

1. Dougados M, et al. Ann Rheum Dis 2014;73:62-8.
2. Pope JE. RMD Open 2020;6:e001084
3. Jacob G, et al.A cognitive behavioural digital health application is effective in improving psychological quality of life in patients with rheumatoid arthritis. OP0097, EULAR 2024 Congress, 12–15 June, Vienna, Austria.

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Posted on 29 July 202429 July 2024