LAUSR

Background Over the past 15 years, there has been a huge shift in the management of RA: the armamentarium has increased but also the way antirheumatic drug are being used has changed, e.g.treat to target. This has implications for how the communication between professional and patient needs to occur: hence shared decision making part of most guidelines. Therefore, healthcare must be organised in a different way: patients should be more involved in their treatment and patient’s self-management should play a very important role. The use of a personal health environment can be an effective tool to involve patients in their disease management and helps to optimise the communication between the patient and health professionals. Objectives The aim of this project was to create an online personal health environment with self-management tools for patients with rheumatoid arthritis (RA) and determine the factors limiting patients to use this environment. Methods Since April 2017 a new online personal health environment was developed in the Netherlands especially for patients with RA, called Reumanet Bernhoven. It includes: 1. an overview of the medication and comorbidities, 2. a graphic of disease-related values (e.g.DAS28, anti-ccp, SR, BMI, 36-Item Short Form Health Survey (SF-36), Health Assessment Questionnaire (HAQ) and RA Impact of Disease (RAID)), 3. a diary, 4. questionnaires such as the different VAS scales (pain, fatigue, general health), Health Assessment Questionnaire HAQ, SF-36 and RAID questionnaire to prepare the outpatient visit. 5. an application to send messages to the health professional. 6. a library with useful disease-specific information. 7. a graphic overview of the DAS28 in combination with the RAID questionnaire to self monitor disease activity. After six months those patients who did not use Reumanet yet were contacted to reveal the cause. Results By November 2017, 997 RA-patients were included in Reumanet Bernhoven. 56% (n=557) used it at least once in this 6 month period. 13% (n=70) of them used the self monitoring tool. The remaining patients, 44% (n=440) were questioned for not using Reumanet at home. 55% (n=242) of these patients responded and 14% (n=62) do want to participate yet, 26% (n=114) did not have a computer or email address, 16% (n=71) did not want to using a digital environment at home. Conclusions Half of the RA-patients used Reumanet at home of which 13% performed self-monitoring of their disease activity in this online personal health environment. Reumanet will be seen as a promising tool to involve patients in their disease management and can be helpful for shared decision making between patient and health professional. In future, more research is needed to optimise patient self-management in a digital health environment in order to increase its usage. Disclosure of Interest None declared