A New Program to Help You Track and Manage Rheumatoid Arthritis.

Scientific Study Title: 

Empowering active self-management of arthritis: Raising the bar with OPERAS (an On-demand Program to EmpoweR Active Self-management)

Study Start Date:

February 2019

End Date:

February 2022

Why Did We Do This Research?

This project builds on a ten-year partnership between researchers, patients, and clinicians to improve the health of people with rheumatoid arthritis. We wanted to see whether we could improve active self-management among people living with rheumatoid arthritis with an online intervention. This included remote counselling from a physiotherapist and the use of an app called OPERAS (On-demand Program to EmpoweR Active Self-management).

Self-management is the ability to manage symptoms and treatments related to living with a chronic disease such as rheumatoid arthritis. It includes some of the following:

  • Balancing activities such as sleeping, resting, and being physically active,
  • Knowing when it is time to seek help from a healthcare provider, and
  • Practicing self-care.

 

What Did We Do?

We divided participants into two groups. One group received the intervention right away, and one group received it after a 27-week delay. The intervention had three components:

  1. A two-hour session that included group education about physical activity and individual counselling with a physiotherapist,
  2. The use of a Fitbit wearable activity tracker and access to a monitoring app (OPERAS) designed for people with rheumatoid arthritis, and
  3. Six counselling phone calls (15-30 minutes each) with a physiotherapist.

During the study, participants used the OPERAS app, which was developed with input from patient partners and is available on both the web and on mobile devices. Using the app, participants monitored and recorded their self-management, disease activity, symptoms, and treatment/medication use. The app also paired with the Fitbit so that participants could see their physical activity levels. Using the app dashboard, participants could see their disease activity scores, symptom ratings, and physical activity levels, and could share this information with their healthcare providers.

To explore the impact of the intervention, we measured participants’ physical activity and inactive time with a small research-grade wearable device called SenseWear Mini. We also looked at participants’ self-management ability; their disease status, including pain, mood, and fatigue; and their self-reported habits (e.g., time spent sitting while awake at home, time spent walking outside), measured through various questionnaires.

 

What Did We Find?

131 people participated in this study, of whom 80% participated during the COVID-19 pandemic. The group that got the intervention right away had a bigger improvement in their ability to self-manage their condition compared to the delayed group. The OPERAS intervention also helped with disease activity, fatigue, depression, and self-reported walking habits.

This research is important because it shows that providing people with rheumatoid arthritis access to physiotherapist counselling paired with self-monitoring tools, like an online app and wearable activity tracking device, can help them to better manage their arthritis and to be more active. In addition, having access to this type of program can also help with managing rheumatoid arthritis disease activity, fatigue, and depression.

The Research Team

Principal Investigators: 

Linda Li PT, PhD; Senior Research Scientist, Arthritis Research Canada – University of British Columbia

Diane Lacaille, MD, MHSc, FRCPC; Scientific Director, Arthritis Research Canada – University of British Columbia

Co-Investigators:

Teresa Liu-Ambrose, PT, PhD; University of British Columbia

Catherine Backman, PhD, OT(C), FCAOT; Research Scientist, Arthritis Research Canada – University of British Columbia

Chris Shaw, PhD; Simon Fraser University

John Esdaile, MD, MPH, FRCPC; Scientific Director Emeritus, Arthritis Research Canada – University of British Columbia

Rob Petrella, MD, PhD, Professor, School of Kinesiology, Western University

Lynne Feehan, BScPT, MSc, PhD, Clinical Associate Professor, Department of Physiotherapy, University of British Columbia

Paul Adam, MSW, Rheumatology Liaison and Outreach Services Coordinator, Mary Pack Arthritis Program

Kimberly Miller, BScPT, MSc, PhD, Senior Leader, Clinical Education & Special Projects, Rehabilitation & Development Management, Sunny Hill Centre for Children; Adjunct Professor, Faculty of Health Sciences, SFU

Collaborators:

Charles Goldsmith, MSc, PhD, Professor, Biostatistics, Simon Fraser University

Alison Hoens, PT, Knowledge Broker, Arthritis Research Canada – University of British Columbia

Cheryl Koehn, President, Arthritis Consumer Experts

 

Who Funded This Research?

The Arthritis Society

 

Technology Partner:

Tactica Interactive

 

Related Publications:

  • Li, L. C., Xie, H., Feehan, L. M., Shaw, C., Lu, N., Ramachandran, S., Wang, E., Therrien, S., Mucha, J., Hoens, A. M., English, K., Davidson, E., Liu-Ambrose, T., Backman, C. L., Esdaile, J. M., Miller, K. J., & Lacaille, D. (2023). Effect of digital monitoring and counselling on self-management ability in patients with rheumatoid arthritis: a randomised controlled trial.Rheumatology (Oxford, England), kead709. Advance online publication. https://doi.org/10.1093/rheumatology/kead709
  • Tam, J., Lacaille, D., Liu-Ambrose, T., Shaw, C., Xie, H., Backman, C. L., Esdaile, J. M., Miller, K., Petrella, R., & Li, L. C. (2019). Effectiveness of an online self-management tool, OPERAS (an On-demand Program to EmpoweR Active Self-management), for people with rheumatoid arthritis: a research protocol.Trials, 20(1), 712. https://doi.org/10.1186/s13063-019-3851-0
  • Leese, J., Backman, C. L., Ma, J. K., Koehn, C., Hoens, A. M., English, K., Davidson, E., McQuitty, S., Gavin, J., Adams, J., Therrien, S., & Li, L. C. (2022). Experiences of self-care during the COVID-19 pandemic among individuals with rheumatoid arthritis: A qualitative study. Health expectations : an international journal of public participation in health care and health policy, 25(2), 482–498. https://doi.org/10.1111/hex.13341
  • Leese, J., Therrien, S., Ramachandran, S., Backman, C. L., Ma, J. K., Koehn, C. L., Hoens, A. M., English, K., Davidson, E., McQuitty, S., Gavin, J., Adams, J., & Li, L. C. (2024). Decision-Making Around COVID-19 Public Health Measures and Implications for Self-Care Activities: Experiences of Persons With Rheumatoid Arthritis. Arthritis care & research, 76(1), 140–152. https://doi.org/10.1002/acr.25262
  • Feehan, L., Xie, H., Lu, N., & Li, L. C. (2024). Twenty-four hour physical activity, sedentary behaviour and sleep profiles in adults living with rheumatoid arthritis: a cross-sectional latent class analysis. JASSB 3, 10. https://doi.org/10.1186/s44167-024-00049-5