Recommendations for future research

CategoryGoalsUnmet need
Adherence and acceptability

  • Real-world long-term cohort data is required.

  • Data from ethically and geographically diverse population.

There are some suggestions that adherence to the use of RMT tend to reduce over time.

Also, the current literature may be biased to include mostly privileged patients for whom access to smart devices or fast internet is not an issue.

Development of tools and standards

  • PROM specific for telemedicine and/or remote monitoring.

  • Validated objective measure of disease activity.

  • IoT tuned to requirements of patients with RA.

  • A universal standard to compare the data acquired via different RMTs is required.

“Smart” pill dispensers that can tie up with physical activity monitors via an IoT approach.

What should be the minimum requirements for RMTs?

Integration of new technologies

  • Vertical integration with EHRs.

  • Improved security using Blockchain technology.

  • Better non-invasive monitoring tools.

There must be a framework to intergrade and test newer emerging technologies.
Validation of existing tools

  • Validation of PROMs for telemedicine and/or remote monitoring.

  • Validation of current tools.

Though several studies have used these tools and have found them useful, there is less information on sensitivity to change or external validation.
Proof of benefit

  • Comparison between remote monitoring + standard care vs. standard care alone.

  • Comparison of PROM based monitoring vs. remote monitoring.

  • Comparison between simple mobile app-based monitoring vs. IoT based monitoring.

Ideally randomized trials are needed to show the superiority of using various grades of technology over usual standard of care.