The effectiveness of smart healthcare for patients with rheumatoid arthritis: A systematic review and meta-analysis

Yin Yu, Meijiao Wang, Hejing Pan, Lin Huang, Haichang Li, Xuanlin Li

Abstract

This study aimed to evaluate the impact of smart healthcare interventions on disease activity, self-efficacy, self-management, functional levels, and quality of life in rheumatoid arthritis (RA) patients, as well as any associated adverse events.

Introduction

Rheumatoid arthritis (RA) is a prevalent systemic autoimmune disease characterized by symmetrical polyarticular pain, primarily affecting synovial tissues and surrounding soft tissues [1–3]. Its estimated prevalence varies significantly, being higher in industrialized countries, with age-standardized rates of 0.38%, 0.35%, and 0.10% in North America, Western Europe, and Southeast Asia, respectively [2,4,5].

Materials and methods

This study was conducted following the Cochrane Handbook for Systematic Reviews of Interventions and the PRISMA guidelines [22,23]. The protocol was pre-registered with the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42024582224. 

Results

The initial search yielded 1,091 records. After removing 187 duplicates, we screened the titles and abstracts of the remaining 904 articles, excluding 842. We then evaluated the full text of 62 articles, resulting in the exclusion of 44, and ultimately included 18 RCTs in this meta-analysis [18,19,29–44].

Discussion

This systematic review and meta-analysis of 18 RCTs assessed the effectiveness of smart healthcare interventions for adults with RA, focusing on disease activity, self-efficacy, functional capacity, RA knowledge, self-management, and qualitative adverse events. Our findings reveal that smart healthcare interventions significantly reduce DAS28, enhance EQ-5D index values, and improve functional capacity, thereby elevating the quality of life for patients with RA.

Conclusions

This systematic review indicates that digitally delivered healthcare interventions can improve key clinical outcomes in patients with RA, including disease activity, functional capacity, and quality of life. However, important limitations – including methodological weaknesses in the original studies.

Citation: Yu Y, Wang M, Pan H, Huang L, Li H, Li X (2026) The effectiveness of smart healthcare for patients with rheumatoid arthritis: A systematic review and meta-analysis. PLoS One 21(1): e0340074. https://doi.org/10.1371/journal.pone.0340074

Editor: Wesam Gouda, Prime Hospital LLC, UNITED ARAB EMIRATES

Received: November 16, 2024; Accepted: December 16, 2025; Published: January 8, 2026

Copyright: © 2026 Yu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: All relevant data are within the manuscript and its Supporting Information files.

Funding: This work was supported by the Natural Science Foundation of Zhejiang Province, China (No. LY24H270004), the Joint project of the State Administration of Traditional Chinese Medicine Science and Technology Department and the Zhejiang Provincial Administration of Traditional Chinese Medicine (No. 2023C03040), the Natural Science Foundation of Zhejiang Province, China (No. Y21H270014), and the Zhejiang Province Traditional Chinese Medicine Science and Technology Project (No. 2020ZZ006).

Competing interests: The authors have declared that no competing interests exist.

Abbreviations: RA, rheumatoid arthritis; CI, confidence interval; RCT, randomized controlled trial; SMD, standardized mean difference; PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses