The MOSKUS project developed an architecture, including a set of tools, for self-management of Spondyloarthritis (SpA). Patients that have undergone diagnosis and early clinical treatment use MOSKUS for self-management by performing assessments, answering questionnaires, and using the patient diary to follow progress. The patient diary can be used for patient-health personnel communication by making the assessment data available to health personnel regularly or when needed. Also, the assessment methods in MOSKUS are available for clinical assessment by health personnel during patient visits.
The MOSKUS concept builds on a solution for self-management. Patients use the solution at home to control the disease based on treat to target. The concept also includes more effective clinical assessment an a solution for patient-health personnel communication for treat-to-target.
We implemented assessment methods, including software for patient-reported outcome measures for BASFI and a combined questionnaire for ASDAS-CRP, ASDAS-ESR, and BASDAI. We also developed prototypes for sensor-based patient-reported outcome measures of rotational exercises.
We selected exercises from the BASMI (thorcal, lumbal, and intermalleolar rotation) and implemented them for clinical assessment and patient-reported outcome measurement. Apertus developed a sensor that can measure rotation around the vertical axis such as cervical rotation, thoracic rotation and hip abduction that is reliable and feasible in clinical practice and in self-management use.
The sensor showed excellent criterion validity and reliability for rotation around the vertical axis in the range of motion from 10 to 120 degrees. The angle can be measured with a precision of less than 1.3 degrees. These findings justify further evaluations of the sensor for measuring cervical rotation, thracic rotation, and hip abduction in patients with SpA. We evaluated the rotation measurement using the sensor in a clinical trial performed with 60 patients.
We implemented a prototype of a self-management support system for patients with SpA based on the concepts above. All assessments are reported to the health cloud that stores these values. The patient can use a diary app to visualise the results. Beyond self-management purposes, the data can also be shown to health personnel. In addition to visualising the data, the patient diary app implements a module for recommendations based on the treat-to-target method. The current heuristic is based on the experiences of health personnel to show the trend.
The MOSKUS project is an interdisciplinary collaboration between the National Competence Center for Rehabilitation (NKRR) at the Diakonhjemmet Hospital, the Sørlandet Hospital, the Norwegian Rheumatism Association (NRF), Norsk Regnesentral (NR), Apertus AS, Tellu AS, and researchers from the De Montfort University, Leicester.
As the cost of health care increases, one way of controlling it is by reducing the number of consultations. This is achieved by using self-management systems. The MOSKUS project will develop smart ICT solutions to support self-management using situational feedback for arthritis, a prevalent and debilitating chronic disease. This system will improve arthritis self-management through coping skills, increased pain management, medication adherence, self-care behaviours, and lifestyle changes.
MOSKUS will use smartphones as a digital assistant for patients with arthritis, where adaptive algorithms will provide tailored self-management guidance that increases the patients' motivation and ability to be compliant with the treatment. The adaptive algorithms will use input captured from biomedical sensors, cameras, microphones and sensors on smartphones, subjective input from the patients, and data
from the medical personnel. Through accessible and user-friendly interfaces and positive psychology, the system will be used to increase the patient's motivation for self-management and adherence to the training programs.
The project will research on estimation models and metrics for Quality of Context and Quality of Experience. These are used as input for the decision making system for the adaptive algorithms in the digital assistant. These decisions are used to feed a cognitive motivation module using positive psychology.
MOSKUS is an ambitious project on a national level with an international potential. It includes research on the Internet of Things (IoT) with sensors, smartphones, and tablets, and combines this with research in the fields of user-experience, usability, privacy, e-inclusion, and ontology-based knowledge management. MOSKUS creates a new market for s ensors and mobile apps in eHealth.