“We are hoping the use of the app will lead to less frequent consultations and appointments by allowing young people to self-manage their JIA more effectively and to also engage remotely with healthcare,” chief investigator Despina Eleftheriou, Great Ormond Street Institute of Child Health, Infection, Immunity, and Physiological Medicine in London, UK, explained to Rheumatology Advisor.
The 3 primary themes of the JIApp were allowing for self-monitoring of JIA symptoms, general well-being, activities, and sleep; enhancing treatment adherence through tracking, reminders, and incentives; and providing education and support. “The initial aim is to enable better self-management for patients, but in the long term, the vision is to have an alert system for notifying healthcare professionals,” Dr. Eleftheriou said.
Both young adults with JIA and healthcare providers were reported to consider the app highly acceptable and useful in a pilot study, which the authors intend to follow up with feasibility studies.8 “We are already working with the National Health Service in pediatric settings to get this adopted,” Dr. Eleftheriou added.
The Potential of New Technologies in JIA
A 2017 review by Coda et al.10 concluded that emerging interactive technologies have great potential to improve management strategies in JIA, including monitoring of disease progression (even during clinically defined remission), improving adherence, encouraging physical activity, and engaging children and adolescents in their own JIA management process.
“These smart devices can gather a very large number of data,” Dr. Coda told Rheumatology Advisor, adding that “it would certainly be valuable to be able to record pain level, physical activity, and adherence to the prescribed medication. The interaction would typically depend, based on the severity of the [patient’s] condition and age.”
The potential of these technologies to improve the quality of care in JIA is immense, according to Dr. Coda. “Interactive online/cloud technology might be of help to ensure that different health outcome measures in JIA [can] be collected anytime and anywhere by the different members of the multidisciplinary pediatric rheumatology team,” she said. She and her colleagues will soon begin a new randomized controlled trial to identify which products might work best.
At the same time, however, Dr. Coda warned that new technologies that share data within registries and in real time present unique data protection and privacy issues that will first need to be resolved before these interactive devices and apps can be introduced into general clinical practice.
- Ravelli A, Martini A. Juvenile idiopathic arthritis. Lancet. 2007;369:767-778.
- Kahn PJ. Juvenile idiopathic arthritis: what the clinician needs to know. Bull Hosp Jt Dis. 2013;7:194-199.
- Magni-Manzoni S. Ultrasound in juvenile idiopathic arthritis. Pediatr Rheumatol Online J. 2016;14:33.
- Vidqvist K-L, Malin M, Varjolahti-Lehtinen T, Korpela MM. Disease activity of idiopathic juvenile arthritis continues through adolescence despite the use of biologic therapies. Rheumatology (Oxford). 2013;52:1999-2003.
- Selvaag AM, Aulie HA, Lilleby V, Flatø B. Disease progression into adulthood and predictors of long-term active disease in juvenile idiopathic arthritis. Ann Rheum Dis. 2016;75:190-195.
- Collado P, Jousse-Joulin S Alcalde M, Naredo E, D’Agostino MA. Is ultrasound a validated imaging tool for the diagnosis and management of synovitis in juvenile idiopathic arthritis? A systematic literature review. Arthritis Care Res. 2012;64:1011-1119.
- Magni-Manzoni S, Malattia C, Lanni S, Ravelli A. Advances and challenges in imaging in juvenile idiopathic arthritis. Nat Rev Rheumatol. 2012;8:329-336.
- Cai RA, Beste D, Chaplin H, et al. Developing and evaluating JIApp: acceptability and usability of a smartphone app system to improve self-management in young people with juvenile idiopathic arthritis. JMIR Mhealth Uhealth. 2017;5:e121.
- Lanni S, Wood M, Ravelli A, Magni Manzoni S, Emery P, Wakefield RJ. Towards a role of ultrasound in children with juvenile idiopathic arthritis. Rheumatology (Oxford). 2013;52:413-420.
- Coda A, Sculley D, Santos D, et al. Harnessing interactive technologies to improve health outcomes in juvenile idiopathic arthritis. Pediatr Rheumatol Online J. 2017;15:40.