LAUSR

Rheumatoid arthritis (RA) outcomes have significantly improved with the treat-to-target paradigm, however this necessitates intensive monitoring. Demand outstrips capacity in rheumatology services, making mobile health (mHealth) an attractive prospect. However, software developers often design without understanding the needs of ultimate users, solving non-existent problems. EULAR’s ‘Points to Consider’ for remote care specifies that interventions “should be developed in collaboration with all stakeholders including the healthcare team … and people with RMDs” as an overarching principle. This study sought to understand existing challenges for end-users, how technology might support care, and the perceived barriers. Semi-structured interviews were devised collaboratively between rheumatologists and computer scientists, informed by discussions with an RA patient group. Key focus topics included daily life, flares, pain management, medications, clinic appointments, and perceived opportunities and barriers. People >18 years old with a diagnosis of RA were recruited whilst awaiting appointments, & in the day unit at Mile End Hospital (Barts Health NHS Trust). Clinicians were recruited from multiple centres across London & South-East England. The study was registered (CMPS ID [43816]). Ethical approval was obtained through the Bloomsbury Research and Ethics Committee (19/LO/1345). Patient interviews were conducted by PC, Clinician interviews were conducted by AMB between October 2019-March 2020. Interviews were transcribed, and coded for themes using grounded theory techniques, identifying central themes. Coders (AMB & PC) utilised consensual coding, ensuring consistency. 21 people with RA and 14 clinicians were interviewed. People with RA’s primary goal is to improve independence and quality and life, whereas clinicians primarily focus on remission. However, both groups identified consensual opportunities and barriers. Key themes with supporting quotes are detailed in table 1: Opportunities for technology to improve care include: utilising remote monitoring to provide a broader picture of disease behaviour, improving access to care & co-ordinating care plans across primary and secondary care, improving the quality of disease education & empower people with RA to self-manage, the need for individualised care, and preservation of the therapeutic relationship when care is delivered remotely. Barriers can be sub-divided into patient, clinician, healthcare system, and technological. Disclosure A. MacBrayne: None. P. Curzon: None. H. Soyel: None. W. Marsh: None. N. Fenton: None. C. Pitzalis: None. F. Humby: None.