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.

BACKGROUND Mobile health applications (apps) are increasing in interest for enhancing patient self-management in rheumatology. Inflammatory arthritis (IA) represents painful chronic conditions impairing quality of life, for which disease-modifying anti-rheumatic drugs (DMARDs) are used to control disease activity and reduce functional disability. DMARDs are increasing in availability (>15 DMARDs in France) and have a wide variety of targets and modes of administration, but their use is associated with risk of adverse effects such as infections. Few apps in rheumatology have been developed with the involvement of patients and health professionals (HPs) and are actually used by patients. Patient education, including e-education, is advocated to improve patients’ autonomy over their own health. Apps may be appropriate tools for self-managing medications, problem-solving or care coordination. OBJECTIVE To develop 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 development was promoted by the French Society of Rheumatology. A mixed-method qualitative–quantitative study including 42 and 344 patients, respectively, identified the impact of IA on daily life, patients’ treatments practices, social relationships, use of health apps and potential use needs. A multidisciplinary team including 7 rheumatologists, 3 patient association representatives and 5 members of a digital company developed the first version of the app via face-to-face meetings and patient feedback during the process. After launch, 2 in-depth users’ tests including 13 patients and 3 rheumatologists led to the app’s current version. The number of app installations, current users, and user requests were collected, as were scores and comments at stores. RESULTS The qualitative study revealed needs for information and counselling, development of a HP–patient partnership, development of skills to cope with daily life and risk situations with treatment aids; 86.8% participants in the quantitative study 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, treatment reminders, global well-being self-assessment, periodic counselling messages, and a diary. Aids for risk situations were based on the French academic recommendations for DMARD management, drug leaflets and websites of national health authorities. The app is free, with no personal data collection. The presentation is a “companion” called Hiboot (“owl” in English). Hiboot was installed 20,500 times from 2017 to 2020, with 4300 regular current users and still-increasing usage curves. Overall, 18,000 requests on treatment self-management were identified over an 8-month period in 2020. Scores were 4.4/5 stars at Android and iOS stores. CONCLUSIONS Hiboot is a free self-management app for patients with inflammatory arthritis developed by a step-by-step process including patients and HPs. The number of current users is substantial. Further evaluation of the Hiboot benefit is needed.