Integration of a medication reminder app into the RABBIT-SpA disease registry to record patient data on daily drug usage

Background: The main goals of the disease registry RABBIT-SpA for axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA) are to analyse the long-term effectiveness and safety of the antirheumatic drugs used for these chronic conditions. While the registry focuses on documenting antirheumatic drugs, the recording of co-medication has been inadequate, despite growing awareness of the importance of comorbidities in the outcomes of rheumatic and musculoskeletal diseases. Research question and objective: The primary objective is the data protection-compliant integration of a medication reminder app into the registry’s existing online documentation system, providing a technically simple solution for participating rheumatologists. Secondary objectives include the direct documentation of medication by patients using the integrated app and the more frequent capture of patient-reported outcome (PRO) parameters. The main research question of this preliminary analysis is the concordance between the anti-rheumatic medication documented by the patient via the app and by the rheumatologist via the registry. Methods: RABBIT-SpA is a disease registry for axSpA and PsA. A study version of the MyTherapy app was developed by expanding the generic app, which primarily records medication and provides medication reminders, to include questions from the RABBIT-SpA patient questionnaire (covering pain, health status, global disease activity, sleep disorders, and skin involvement). Patients use their own Android or iOS smartphones and provide informed consent for participation. Results: The integration process was successfully implemented. Personalized QR codes were generated from the registry documentation system, enabling patients to download the study version of the MyTherapy app and link their data using a second pseudonym. As of now, 367 patients have been invited to participate, with 139 consenting and 76 successfully using the app. App users are generally younger and more often male compared to the overall registry cohorts. On average, 4.7 medications were recorded per patient (range 1–42), with a high concordance (94%) between the medications documented in the app and those in the registry. The proportion of patients with polypharmacy (defined as the simultaneous documentation of five or more medications) is 25%. Discussion: The integration of the medication reminder app into the RABBIT-SpA registry was successfully achieved in a data protection-compliant manner. The antirheumatic drugs documented in the app were concordant to the registry data. The integration of an app to an ongoing disease registry offers the possibility of supplementing data from the registry with patient generated data.