The REmote MOnitoring of Rheumatoid Arthritis (REMORA)
Musculoskeletal
10 Oct 2018

The REmote MOnitoring of Rheumatoid Arthritis (REMORA)

Musculoskeletal
Published Date: 10 Oct 2018

The REmote MOnitoring of Rheumatoid Arthritis (REMORA) study addresses the need for more reliable ongoing symptom monitoring using a smartphone app. Often patients have appointments months apart so it’s difficult to recall from memory symptom variations since their last consultation.

  • Patients reported changes in their behaviour due to REMORA (see feedback), including use of technology (e.g. the diary function and camera within their phone) to capture disease activity to inform consultations, which has led to changes in their treatment.
  • Post-testing clinics indicated that additional information provided through app data entry could also influence the way that consultations are delivered. One rheumatologist commented that she had changed the way she conducts consultations in response to the study (see blog).
  • REMORA has featured as a case study demonstrating good digital health as part of the NHS Digital Academy.
  • This project (which took a co-design approach with patients to produce this app) was recognised nationally by winning Abbvies’ Enabling Patients with Technology prize at the Patients as Partners awards 2017.
  • The IT team at Salford Royal Foundation Trust stated they will approach implementation of similar technology initiatives differently at the Trust in the future in light of learning from the REMORA study.

REMORA is novel because the data from the app flows directly into the Trusts electronic patient record, to facilitate shared decision making between patient and clinicians. The Chief Clinical Information Officer at Salford Royal Foundation Trust and NHS Digital believe the success of this approach could inform future work locally, regionally (through the Greater Manchester Health and Social Care Partnership), and at a national level.

Contribution of CLAHRC Greater Manchester 

NIHR CLAHRC GM co-funded the project, project managed, facilitated recruitment, provided communications support and qualitative evaluation expertise, in collaboration with our partners at The University of Manchester, Arthritis Research UK and SRFT. Without NIHR CLAHRC GMs input, this project would not have been possible.

What happened next?

REMORA is novel because the data from the app flows directly into the Trusts electronic patient record, to facilitate shared decision making between patient and clinicians. The Chief Clinical Information Officer at Salford Royal Foundation Trust and NHS Digital believe the success of this approach could inform future work locally, regionally (through the Greater Manchester Health and Social Care Partnership), and at a national level.

An ongoing partnership has formed with the team developing the Citizen Identity Programme, through workshop learning from the REMORA project, and plans for the next phases of work, are informing NHS digitals future tool.

Once funding is achieved, it is planned that a follow on study will develop the app and associated infrastructure further and implement at additional Trust sites, ultimately generating a blueprint for how apps can be integrated into the NHS.