Accepted for/Published in: JMIR Formative Research
Date Submitted: Mar 31, 2024
Date Accepted: Sep 3, 2024
Development of the Happy Hands self-management app for people with hand osteoarthritis: a feasibility study
ABSTRACT
Background:
Patient education, hand exercises and the use of assistive devices are recommended as first-line treatment for people with hand osteoarthritis (OA). However, the quality-of-care services for this patient group is sub-optimal in primary care.
Objective:
The primary objective of this study was to develop and test the feasibility of an app-based self-management intervention for people with hand OA - the Happy Hands app.
Methods:
The development and feasibility testing of the Happy Hands app followed the two first phases of the Medical Research Council (MRC) framework for development and evaluation of complex interventions. The development was conducted in close collaboration with patient research partners (PRPs) and guided by Social Cognitive Theory. A pre-post mixed methods design was used to explore feasibility in terms of usefulness, satisfaction, and adherence with the app, change in pain, stiffness, activity performance of the hand, grip strength and self-reported quality of care over a 3-month period. Focus group interviews were conducted to explore the participants’ experience with using the app. Men and women >40 years of age diagnosed with painful, symptomatic hand OA were recruited.
Results:
The first version of the app was based on the needs and requirements of the PRPs, evidence-based treatment recommendations, and experiences from people living with hand OA. It was designed to guide the participants through a series of questionnaires, informative videos, exercise videos, quizzes, and customized feedback across 3 months. The feasibility study included 71 participants (64 years (SD 8) years old, 86% women), of which 57 completed assessment after 3 months. All measures improved significantly from baseline to 3-months follow-up. Participants were highly satisfied and considered the app very useful. Focus group interviews underscored these results. Feedback from the focus group participants also led to the implementation of several enhancements in the second version of the app.
Conclusions:
The Happy Hands app was considered highly usable and useful by patients. The results further indicated that the app may improve quality of care, grip strength, activity performance, pain and stiffness. However, definitive conclusions need to be confirmed in a powered randomized controlled trial. Clinical Trial: The feasibility study was prospectively registered in ClinicalTrials.gov (NCT05150171) 21/08/2019
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