Digital Psychological Intervention for Inflammatory Rheumatic Diseases

Importance: Patients with inflammatory rheumatic diseases (IRDs) frequently experience psychological distress; however, access to psychological support remains limited. Objective: To investigate the effectiveness of a digital psychological intervention for individuals with IRDs. Design, Setting, and Participants: Participants aged 18 years or older were recruited across Germany between February 22 and June 4, 2024, if they had been diagnosed with rheumatoid arthritis, psoriatic arthritis, or systemic lupus erythematosus and reported psychological distress and reduced quality of life. Interventions: Participants were randomized to either a self-guided digital psychological intervention or a treatment-as-usual control condition. Main Outcomes and Measures: The primary outcomes were change in psychological distress (German version of the Hospital Anxiety and Depression Scale) and quality of life (Assessment of Quality of Life-8 Dimensions) from baseline to 3 months. Secondary outcomes included changes in self-efficacy, health literacy, perceived stress, functional impairment, depression, and anxiety. Results: A total of 102 participants (mean [SD] age, 47.2 [12.9] years; 92 [90.2%] female) were randomized to an intervention group (n = 52) or a control group (n = 50). The intervention group showed a significantly greater reduction in psychological distress at the 3-month follow-up (least-squares mean [SE] difference, -3.60 [1.07]; 95% CI, -5.73 to -1.47; P < .001; Cohen d = -0.71) and a greater improvement of quality of life (least-squares mean [SE] difference, 0.04 [0.02]; 95% CI, 0.00-0.09; P = .047; Cohen d = 0.49). A significantly greater number of participants in the intervention group experienced a clinically meaningful improvement in psychological distress (29 [59.2%] vs 17 [34.0%]; P = .02) and quality of life (27 [55.1%] vs 16 [32.0%]; P = .03) compared with the control group. Secondary outcomes measures showed a similar pattern of improvement, except for functional impairment. No adverse events related to the intervention were reported. Conclusions and Relevance: This pilot randomized clinical trial supports the effectiveness and safety of a digital psychological intervention in individuals with IRDs. These findings suggest that such digital interventions could be a valuable, scalable approach to addressing mental health needs in rheumatology. Trial Registration: German Clinical Trials Register (DRKS) identifier: DRKS00032862.