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Joint Bone Spine
Volume 85, n° 6
pages 709-714 (décembre 2018)
Doi : 10.1016/j.jbspin.2017.11.015
accepted : 29 November 2017
Original Articles

An e-health interactive self-assessment website (Sanoia®) in rheumatoid arthritis. A 12-month randomized controlled trial in 320 patients

Laure Gossec a, b, , Alain Cantagrel c, Martin Soubrier d, Jean-Marie Berthelot e, Jean-Michel Joubert f, Bernard Combe g, Wienia Czarlewski f, Daniel Wendling h, Emmanuelle Dernis i, Laurent Grange j, Catherine Beauvais k, Aleth Perdriger l, Henri Nataf m, Maxime Dougados n, o, p, Hervé Servy q
a Institut Pierre-Louis d’épidémiologie et de santé publique (UMRS 1136), Sorbonne universités, UPMC université Paris 06, GRC-UPMC 08 (EEMOIS), 75013 Paris, France 
b Rheumatology department, hôpital Pitié-Salpêtrière, AP–HP, 75013 Paris, France 
c Rheumatology department, hôpital de Purpan, CHU de Toulouse, 31300 Toulouse, France 
d Rheumatology department, CHU Gabriel-Montpied, 63000 Clermont-Ferrand, France 
e Rheumatology department, CHU de Nantes, 44093 Nantes cedex 01, France 
f UCB Pharma, 92700 Colombes, France 
g Rheumatology department, hôpital Lapeyronie, Montpellier université, 34295 Montpellier cedex 5, France 
h Rheumatology department, CHRU Jean-Minjoz, 25030 Besançon, France 
i Rheumatology department, centre hospitalier du Mans, 72037 Le Mans, France 
j Rheumatology department, CHU Grenoble Alpes-hôpital Sud, 38130 Echirolles, France 
k Rheumatology department, hopital Saint-Antoine, AP–HP, 75012 Paris, France 
l Rheumatology department, CHR hôpital Sud, 35033 Rennes cedex 9, France 
m Private practice rheumatology, 78200 Mantes-La-Jolie, France 
n Paris descartes university, 75014 Paris, France 
o Department of rheumatology, hôpital Cochin, Assistance publique–Hôpitaux de Paris, 75014 Paris, France 
p Inserm (U1153), clinical epidemiology and biostatistics, PRES Sorbonne Paris-Cité, 75014 Paris, France 
q Sanoia, e-Health services, 13420 Gémenos, France 

Corresponding author. Service de rhumatologie, hôpital Pitié-Salpétrière, 47-83, boulevard de l’Hôpital, 75013 Paris France.Service de rhumatologie, hôpital Pitié-Salpétrière, 47-83, boulevard de l’Hôpital, 75013 Paris France.

In this randomized controlled trial, giving access to the interactive Sanoia e-health platform led to a small improvement in patient-perceived patient-physician interactions.
E-Health platforms are promising adjuncts to physician care in RA.
Although mean satisfaction with the platform was very high, around a quarter of the patients did not use the interactive platform.
Future studies of e-health should measure not only patient satisfaction but a combination of both patient satisfaction and utilization.

The full text of this article is available in PDF format.

Sanoia is an online interactive electronic e-health platform developed to allow patient self-assessment and self-monitoring. The objective was to assess in rheumatoid arthritis (RA) patients, the efficacy on patient-physician interactions, of giving access to Sanoia.


In this French, multi-center, 12-months randomized controlled trial (CarNET: NCT02200068), patients with RA and internet access were randomized to: access without incentives to the Sanoia platform after minimal training, or usual care. The primary outcome was the change from baseline in patient-physician interactions, by the patient-reported Perceived Efficacy in Patient–Physician Interactions (PEPPI-5) questionnaire. The number of accesses to Sanoia was recorded and satisfaction with the platform was assessed through a 0–10 numeric rating scale. Analyses were in intention to treat (ITT), on SAS.


Of 320 RA patients (159 Sanoia versus 161 usual care), mean (standard deviation) age was 57.0 (12.7) years, mean (SD) disease duration was 14.6 (11.1) years, 216 (67.5%) were taking a biologic and 253 (79.1%) were female. Mean (SD) PEPPI scores at baseline and 12 months were 38.6 (8.2) and 39.2 (8.0) (delta=+0.60 [5.52]) versus 39.7 (7.3) and 38.8 (8.0) (delta=−0.91 [6.08]) in the Sanoia and control group, respectively (P =0.01). Although mean satisfaction with the platform was very high (1.46 [1.52]), 41 patients (25.7%) never accessed Sanoia.


Giving RA patients access to the interactive Sanoia e-health platform led to a small improvement in patient-perceived patient-physician interactions. A disjunction between patient satisfaction and access to the platform was noted. E-Health platforms are promising in RA.

The full text of this article is available in PDF format.

Keywords : Rheumatoid arthritis, Disease activity, Patient attitude to health, E-health, Electronic health records, Patient-reported outcome measures, Quality of life, Quality of health care

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