Advantages of remote monitoring the activity of patients with axial spondylitis (progress study)

Abstract

Aim. To improve the quality of treatment ofpatients with spondyloarthrities based on analysis of adherence to therapy and its timely correction by regular remote monitoring the activity of the disease. Materials and methods. 46 patents with axial spondylitis (ankylosing spondylitis, non-radiographic spondylitis) were interviewed by phone once in 4 weeks for 18 months with a 3 month interval after 12 months. 96 patients underwent routine outpatient examination for the evaluation of the main parameters of the disease. Results and discussion. Arbitrarily examined patients with spondyloarthritis reported poor compliance with therapy and its low efficiency. During 18 months, 79% of the patients were recommended treatment with TNF-a inhibitors. Only 18.5% of them in the remote monitoring group failed to reach the BASDAI index < 4 whereas 73.9% of the patients examined remotely for 1 year had low activity of the disease or its partial remission. An increased period between two phone interviews from 1 to 3 months in 58.6% patients with low activity of the disease was associated with impaired adherence to therapy (decreased intake of the anti-inflammatory drug or its withdrawal) that did not lead to enhancement of activity during 3 months after the change in the treatment. Conclusion. Remote monitoring of activity of the disease (one phone interview every 4 weeks) allows to decrease it or reach remission in 73.9% of the patients with axial spondyloarthritis. The decrease in the frequency of telephone calls to one every 3 months results in the impairment of compliance with therapy but does not lead to increase of disease activity in the short run.