REmote MOnitoring in Rheumatoid Arthritis (REMORA)

Project Overview

Treatment for patients with RA is guided by changes in disease activity; however, clinicians have few, if any, objective measures (‘outcomes’) relating to activity between clinic visits. This study will design, implement and evaluate a system of remote data collection of patient outcomes (e.g. pain, fatigue) from patients with RA using a Smartphone app. The electronic patient reported outcomes (ePROS) will be linked to the patient’s electronic medical record (EPR). Anonymised patient data will be used to generate a research database of frequently measured ePROS.

Start: May 2015

End: March 2017

Funded by: Arthritis Research UK, CLAHRC Greater Manchester

Disease Area Involved

Rheumatoid Arthritis


The study has 3 rounds:

  • Identifying ‘outcomes’ of importance and incorporating these ‘ePROS’ into a prototype smartphone app
  • Piloting the app with a small group of patients (8) and refining the app in response to their feedback
  • Testing the app with a larger group of patients (24) and compelling a toolkit of ‘lessons learnt’ during the development of the app.


The project will determine the views of stakeholders (patients, clinical staff including GPs, hospital managers, IT staff and researchers) with regard to the app being developed. Data will be obtained via:

  • qualitative interviews with key stakeholders at each stage of the study
  • audio recordings of clinical consultations (pre and post use of the Smartphone app)
  • health economics questionnaires

Data collected within the app will also inform the project’s goals.


Benefits for patient and practitioners will include better information for clinical consultations patient self-management. Triaging of outpatient appointments in the future, based on self-reported data, could lead to cost savings for both patients and service providers. Researchers could benefit from the availability of temporarily rich patient reported data, e.g. for measuring the frequency and severity of disease flares.

Intended Outcomes

At the end of the study we will have developed a fully functioning Smartphone app. Patients will be able to record ePROS on a regular basis and these data will be linked to their electronic patient record at the hospital. A research database of frequently measured ePROS will also be available. A ‘toolkit’ of lessons learnt during the development of the app will be produced to inform the implementation of similar remote monitoring projects within the NHS.

Researchers Involved

Dr Will Dixon

Caroline Sanders

Lynn Austin

Dr John Ainsworth

Matthew Machin

Linda Davies