{
  "abstract": "Introduction/objectives: Patient Global Assessment of Disease Activity (PtGADA), pain, and Routine Assessment of Patient Index Data 3 (RAPID3) are core patient-reported outcomes in inflammatory arthritis. We examined whether digital self-management engagement was associated with their long-term trajectories.\n\nMethod: This retrospective cohort included 3513 adults using a certified digital self-management application. Patients were grouped by completion of 0, 1–2, or ≥3 structured self-management plans. Longitudinal models with patient-level cluster-robust standard errors estimated post-baseline change trajectories. Sensitivity analyses addressed differential attrition, measured confounding, and reverse causality.\n\nResults: Of 2895 patients with baseline PtGADA, 1026 (35.4%) contributed post-baseline observations. Patients completing ≥3 plans had more favourable PtGADA, pain, and RAPID3 trajectories than zero-plan patients (group-effect p=6.2×10−5, p=0.0055, and p=0.0044, respectively), without diverging slopes. At weeks 12–48, PtGADA improved by 11.1–12.1 points and pain by 7.2–7.3 points in the high-engagement group. After attrition weighting, PtGADA remained significant, RAPID3 retained a significant joint group effect, and pain was no longer significant.\n\nConclusions: Higher engagement was most robustly associated with more favourable long-term PtGADA trajectories; support for pain was directionally similar but statistically more limited, and RAPID3 findings were the least consistent of the three outcomes. These results describe an engagement-associated phenotype rather than a causal treatment effect and support its evaluation as a potential marker of sustained digital engagement in future prospective stratification studies.\n\nKey Points\n\n• In this real-world cohort of 3513 patients with inflammatory arthritis, higher digital self-management engagement was most robustly associated with more favourable PtGADA trajectories; the association with pain was directionally similar but less robust, while RAPID3 findings were less consistent.\n\n• Engagement-group trajectories were approximately parallel, and the findings remained directionally consistent in analyses examining sensitivity to differential follow-up, measured baseline differences, and reverse-causality concerns, although statistical significance varied by outcome and landmark.\n\n• The engagement-outcome association was directionally consistent across multiple sensitivity analyses addressing measured confounding and differential follow-up, although temporal exposure assignment could not be established and residual reverse-causality bias cannot be excluded.\n\n• Digital self-management engagement, operationalised by action-plan completion, represents a potential marker of sustained digital engagement for future prospective stratification studies, rather than a validated tool for baseline risk stratification.\n\nSupplementary information: The online version contains supplementary material available at https://doi.org/10.1007/s10067-026-08425-z.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Internal Medicine, Bogomolets National Medical University, 13 Blvd Shevchenka, Kyiv, 01032 Ukraine",
    "Medical Center Medical Clinic Blagomed LLC, Kyiv, Ukraine",
    "Midaia GmbH, Heidelberg, Germany",
    "Rheumatology Department, Kiel Campus, Universitätsklinikum Schleswig-Holstein, Kiel, Germany",
    "Department of Rheumatology, St. Elisabeth-Hospital Meerbusch-Lank, Hauptstr. 74-76, 40668 Meerbusch, Germany",
    "Department of Rheumatology & Hiller Research Center, Medical Faculty, University Hospital Düsseldorf, Heinrich Heine University, Düsseldorf, Germany"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "Dmytro Fedkov",
      "orcid": "0000-0001-7965-9438"
    },
    {
      "affs": [
        0
      ],
      "name": "Danylo Yevstifeiev",
      "orcid": "0009-0002-4166-6397"
    },
    {
      "affs": [
        3
      ],
      "name": "Jan Leipe",
      "orcid": "0000-0001-9684-9700"
    },
    {
      "affs": [
        0
      ],
      "name": "Oleg Iaremenko",
      "orcid": "0000-0003-2095-5819"
    },
    {
      "affs": [
        0
      ],
      "name": "Daria Koliadenko",
      "orcid": "0000-0002-9562-9367"
    },
    {
      "affs": [
        0
      ],
      "name": "Liubov Petelytska",
      "orcid": "0000-0001-8330-8681"
    },
    {
      "affs": [
        2
      ],
      "name": "Felix Lang",
      "orcid": "0000-0001-6102-2674"
    },
    {
      "affs": [
        2
      ],
      "name": "Abdullah Khalil",
      "orcid": "0009-0003-9969-5462"
    },
    {
      "affs": [
        4
      ],
      "name": "Türker Kurt",
      "orcid": "0000-0002-5801-630X"
    },
    {
      "affs": [
        4,
        5
      ],
      "name": "Stefan Vordenbäumen",
      "orcid": "0000-0001-5725-5483"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/7qgrabnzkjy26.bib",
  "cited_by": 0,
  "doi": "10.1007/s10067-026-08425-z",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13723565/",
  "id": "7qgrabnzkjy26",
  "issns": [
    "0770-3198",
    "1434-9949"
  ],
  "landing_url": "https://doi.org/10.1007/s10067-026-08425-z",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Article"
    ],
    [
      "openalex",
      "3600|Mobile Health and mHealth Applications"
    ]
  ],
  "openalex": "W7214804668",
  "pdf_url": "https://link.springer.com/content/pdf/10.1007/s10067-026-08425-z.pdf",
  "pmcid": "PMC13723565",
  "pmid": "42809036",
  "published": "2026-09-29",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/7qgrabnzkjy26.ris",
  "sources": [
    {
      "first_seen": "2026-11-04T12:22:10Z",
      "native_id": "PMC13723565",
      "source": "pmc",
      "url": "https://doi.org/10.1007/s10067-026-08425-z"
    }
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  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:F27",
      "subfield": "general"
    }
  ],
  "title": "Digital self-management engagement and long-term patient-reported outcome trajectories in inflammatory arthritis: a real-world retrospective cohort study",
  "title_text": "Digital self-management engagement and long-term patient-reported outcome trajectories in inflammatory arthritis: a real-world retrospective cohort study",
  "type": "peer-reviewed",
  "updated_at": "2026-11-05T12:20:21Z",
  "url": "https://research.draconitic.com/paper/7qgrabnzkjy26",
  "venue": "Clinical Rheumatology",
  "versions": []
}