Development and real-life use assessment of a self-management smartphone application for patients with inflammatory arthritis. A user-centred step-by-step approach

Catherine Beauvais; Thao Pham; Guillaume Montagu; Sophie Gleizes; Francesco Madrisotti; Alexandre Lafourcade; Céline Vidal; Guillaume Dervin; Pauline Baudard; Sandra Desouches; Florence Tubach; Julian Le Calvez; Marie de Quatrebarbes; Delphine Lafarge; Laurent Grange; Françoise Alliot-Launois; Henri Jeantet; Marie Antignac; Sonia Tropé; Ludovic Besset; Jérémie Sellam; Therapeutic patient education group of the French Society of Rheumatology and Club Rhumatismes et Inflammations

doi:10.1371/journal.pone.0272235

Development and real-life use assessment of a self-management smartphone application for patients with inflammatory arthritis. A user-centred step-by-step approach

PLoS One. 2022 Sep 15;17(9):e0272235. doi: 10.1371/journal.pone.0272235. eCollection 2022.

Authors

Catherine Beauvais¹, Thao Pham², Guillaume Montagu³, Sophie Gleizes^{3

4}, Francesco Madrisotti^{3

5}, Alexandre Lafourcade^{6

7}, Céline Vidal⁸, Guillaume Dervin⁹, Pauline Baudard¹⁰, Sandra Desouches¹, Florence Tubach^{6

7}, Julian Le Calvez¹¹, Marie de Quatrebarbes¹¹, Delphine Lafarge¹², Laurent Grange¹³, Françoise Alliot-Launois¹³, Henri Jeantet¹¹, Marie Antignac^{14

15}, Sonia Tropé¹⁶, Ludovic Besset¹¹, Jérémie Sellam^{1

17}; Therapeutic patient education group of the French Society of Rheumatology and Club Rhumatismes et Inflammations

Affiliations

¹ Service de Rhumatologie, Hôpital Saint Antoine, Assistance Publique Hôpitaux de Paris (AP-HP), Sorbonne Université, Paris, France.
² Service de Rhumatologie, Hôpital Sainte Marguerite, Aix Marseille Univ, Assistance Publique Hôpitaux de Paris (APHM), Marseille, France.
³ Département de Recherche, Unknowns, Conseil en Stratégie et Innovation, Paris, France.
⁴ Laboratoire d'Anthropologie Sociale (LAS), Collège de France/EHESS/EPHE, Paris, France.
⁵ Centre de National de la Recherche Scientifique (CNRS), Laboratoire CERMES3 (CNRS-EHESS-INSERM), Université de Paris, Paris, France.
⁶ Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, INSERM, Paris, France.
⁷ Département de Santé Publique, Centre de Pharmacoépidémiologie (Cephepi), CIC-1422, Hôpital Pitié Salpêtrière, Sorbonne Université, APHP, Paris, France.
⁸ Clinique Beau Soleil, Montpellier, France.
⁹ Clinique Juge, Institut Médical Sport Santé Marseille, Marseille, France.
¹⁰ Service de Rhumatologie, Centre Hospitalo-Universitaire Caen, Caen, France.
¹¹ Unknowns, Conseil en Stratégie et Innovation, Paris, France.
¹² Association France Spondyloarthrite (AFS), Tulle, France.
¹³ AFLAR Association Française de Lutte Anti rhumatismale (AFLAR), Paris, France.
¹⁴ Service de Pharmacie, Hôpital Saint Antoine, Assistance Publique Hôpitaux de Paris (AP-HP), Sorbonne Université, Paris, France.
¹⁵ Equipe d'Épidémiologie Intégrative, INSERM U 970, PARCC, Paris, France.
¹⁶ Association Nationale de Défense Contre l'Arthrite Rhumatoïde (ANDAR), Paris, France.
¹⁷ Centre de Recherche Saint-Antoine (CRSA), INSERM UMRS_938, FHU PaCeMM, Paris, France.

Abstract

Background: Mobile health applications (apps) are increasing in interest to enhance patient self-management. Few apps are actually used by patients and have been developed for patients with inflammatory arthritis (IA) treated with disease-modifying anti-rheumatic drugs which use entails risk of adverse effects such as infections.

Objective: To develop Hiboot, a self-management mobile app for patients with IA, by using a user-centred step-by-step approach and assess its real-life use.

Methods: The app development included first a qualitative study with semi-guided audiotaped interviews of 21 patients to identify the impact of IA on daily life and patient treatments practices and an online cross-sectional survey of 344 patients to assess their health apps use in general and potential user needs. A multidisciplinary team developed the first version of the app via five face-to-face meetings. After app launch, a second qualitative study of 21 patients and a users' test of 13 patients and 3 rheumatologists led to the app's current version. The number of app installations, current users and comments were collected from the Google Play store and the Apple store.

Results: The qualitative study revealed needs for counselling, patient-health professional partnership, and skills to cope with risk situations; 86.8% participants would be ready to use an app primarily on their rheumatologist's recommendation. Six functionalities were implemented: a safety checklist before treatment administration, aids in daily life situations based on the French academic recommendations, treatment reminders, global well-being self-assessment, periodic counselling messages, and a diary. The Hiboot app was installed 20,500 times from September 2017 to October 2020, with 4300 regular current users. Scores were 4.4/5 stars at Android and iOS stores.

Conclusion: Hiboot is a free self-management app for patients with IA developed by a step-by-step process including patients and health professionals. Further evaluation of the Hiboot benefit is needed.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Antirheumatic Agents*
Arthritis*
Cross-Sectional Studies
Humans
Mobile Applications*
Self-Management*
Smartphone

Substances

Antirheumatic Agents

Grants and funding

This study was promoted and funded by the French Society of Rheumatology. The French Society of Rheumatology received an institutional grant from (in alphabetical order): Abbvie, Biogen, Janssen, Lilly, Merck Sharp & Dohme, Novartis, Nordic Pharma, Roche France and Pfizer. The pharmaceutical companies were not involved in the app’s general design, development or content, study process, data collection, interpretation, manuscript writing or decision to publish. The grant was used to pay the researchers for the qualitative studies, the app development and communication. All other authors did not receive any honoraria for this study.