mHealth technologies for osteoarthritis self-management and treatment: A systematic review

Choi, Wonchan; Zheng, Hua; Franklin, Patricia D.; Tulu, Bengisu

doi:10.1177/1460458217735676

Cited by 52 publications

(63 citation statements)

References 45 publications

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“…Importantly, recent osteoarthritis treatment and management guidelines endorse patient self-management as a means to increase self-awareness of symptoms and better prepare patients to assume active roles in shared medical decision making [ 8 ]. mHealth can enable patient self-management through the use of wearable aides for activity monitoring and behavioral change using personalized, real-time feedback [ 9 ], through acquisition of new knowledge, and by enhancing patient-provider communication [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Co-Design in the Development of a Mobile Health App for the Management of Knee Osteoarthritis by Patients and Physicians: Qualitative Study

Mrklas

Barber

Campbell‐Scherer

et al. 2020

JMIR Mhealth Uhealth

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Background Despite a doubling of osteoarthritis-targeted mobile health (mHealth) apps and high user interest and demand for health apps, their impact on patients, patient outcomes, and providers has not met expectations. Most health and medical apps fail to retain users longer than 90 days, and their potential for facilitating disease management, data sharing, and patient-provider communication is untapped. An important, recurrent criticism of app technology development is low user integration design. User integration ensures user needs, desires, functional requirements, and app aesthetics are responsive and reflect target user preferences. Objective This study aims to describe the co-design process for developing a knee osteoarthritis minimum viable product (MVP) mHealth app with patients, family physicians, and researchers that facilitates guided, evidence-based self-management and patient-physician communication. Methods Our qualitative co-design approach involved focus groups, prioritization activities, and a pre-post quality and satisfaction Kano survey. Study participants included family physicians, patient researchers and patients with knee osteoarthritis (including previous participants of related collaborative research), researchers, key stakeholders, and industry partners. The study setting was an academic health center in Southern Alberta. Results Distinct differences exist between what patients, physicians, and researchers perceive are the most important, convenient, desirable, and actionable app functional requirements. Despite differences, study participants agreed that the MVP should be electronic, should track patient symptoms and activities, and include features customized for patient- and physician-identified factors and international guideline-based self-management strategies. Through the research process, participants negotiated consensus on their respective priority functional requirements. The highest priorities were a visual symptom graph, setting goals, exercise planning and daily tracking, and self-management strategies. The structured co-design with patients, physicians, and researchers established multiple collaborative processes, grounded in shared concepts, language, power, rationale, mutual learning, and respect for diversity and differing opinions. These shared team principles fostered an open and inclusive environment that allowed for effective conceptualization, negotiation, and group reflection, aided by the provision of tangible and ongoing support throughout the research process, which encouraged team members to question conventional thinking. Group-, subgroup-, and individual-level data helped the team reveal how and for whom perspectives about individual functional requirements changed or remained stable over the course of the study. This provided valuable insight into how and why consensus emerged, despite the presence of multiple and differing underlying rationales for functional requirement prioritization. Conclusions It is feasible to preserve the diversity of perspectives while negotiating a consensus on the core functional requirements of an mHealth prototype app for knee osteoarthritis management. Our study sample was purposely constructed to facilitate high co-design interactivity. This study revealed important differences between the patient, physician, and researcher preferences for functional requirements of an mHealth app that did not preclude the development of consensus.

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Section: Introductionmentioning

confidence: 99%

Co-Design in the Development of a Mobile Health App for the Management of Knee Osteoarthritis by Patients and Physicians: Qualitative Study

Mrklas

Barber

Campbell‐Scherer

et al. 2020

JMIR Mhealth Uhealth

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“…Self-management in the form of digitally supported rehabilitation is a striking candidate for digital interventions supporting patients with musculoskeletal pain [ 9 ]. Proof-of-concept studies have consistently shown promising results in terms of clinical endpoints such as pain reduction for patients engaging in the app.…”

Section: Introductionmentioning

confidence: 99%

Implementing Systematically Collected User Feedback to Increase User Retention in a Mobile App for Self-Management of Low Back Pain: Retrospective Cohort Study

Clement¹,

Lorenz²,

Ulm³

et al. 2018

JMIR Mhealth Uhealth

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BackgroundPromising first results for Kaia, a mobile app digitalizing multidisciplinary rehabilitation for low back pain, were recently published. It remains unclear whether the implementation of user feedback in an updated version of this app leads to desired effects in terms of increased app usage and clinical outcomes.ObjectiveThe aim is to elucidate the effect on user retention and clinical outcomes of an updated version of the Kaia app where user feedback was included during development.MethodsUser feedback of the initial app versions (0.x) was collected in a quality management system and systematically analyzed to define requirements of a new version. For this study, the anonymized data of Kaia users was analyzed retrospectively and users were grouped depending on the available version at the time of the sign-up (0.x vs 1.x). The effect on the duration of activity of users in the app, the number of completed exercises of each type, and user-reported pain levels were compared.ResultsOverall, data of 1251 users fulfilled the inclusion criteria, of which 196 users signed up using version 0.x and 1055 users signed up with version 1.x. There were significant differences in the demographic parameters for both groups. A log-rank test showed no significant differences for the duration of activity in the app between groups (P=.31). Users signing up during availability of the 1.x version completed significantly more exercises of each type in the app (physical exercises: 0.x mean 1.99, SD 1.61 units/week vs 1.x mean 3.15, SD1.72 units/week; P<.001; mindfulness exercises: 0.x mean 1.36, SD 1.43 units/week vs 1.x mean 2.42, SD 1.82 units/week; P<.001; educational content: 0.x mean 1.51, SD 1.42 units/week vs 1.x mean 2.71, SD 1.89 units/week; P<.001). This translated into a stronger decrease in user-reported pain levels in versions 1.x (F1,1233=7.084, P=.008).ConclusionsDespite the limitations of retrospective cohort studies, this study indicates that the implementation of systematically collected user feedback during development of updated versions can contribute to improvements in terms of frequency of use and potentially even clinical endpoints such as pain level. The clinical efficiency of the Kaia app needs to be validated in prospective controlled trials to exclude bias.

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“…Of the 26 included articles, one reported a priori protocol registration 7 and four stated reporting was based on the PRISMA guideline for systematic reviews. 7,30,37,39 Adam 20 World of Urology Prostate Cancer Athilingam 21 JMIR Cardiology a Heart Failure Bhattarai 22 Pain Medicine Arthritic Pain Garcia-Cruz 23 Actas Urologicas Espanolas Men's sexual disorders Jupp 24 Pediatric Blood and cancer Cancer/Oncology Lee 25 JMIR mHealth and uHealth a Chronic Kidney Disease Luo 26 Journal of Clinical Rheumatology Rheumatoid Arthritis Rey 27 Neurologica Parkinson's Disease Svendsen 28 Journal of Dermatological Treatment Psoriasis Choi 29 Health Informatics Journal a Osteoarthritis Grainger 30 JMIR mHealth and uHealth a Rheumatoid Arthritis Martinez 31 JMIR Diabetes a Diabetes Rossi 32 mHealth a Diabetes Sobnath 33 JMIR mHealth and uHealth a Chronic Obstructive Pulmonary Disease Xie 34 JMIR mHealth and uHealth a Cardiovascular Disease Arnhold 35 JMIR a Diabetes Brouard 36 Annals of Medicine Cancer Brzan 37 Journal of Medical Systems a Diabetes Con 38 JMIR mHealth and uHealth a Inflammatory Bowel Disease Machado 7 Best Practice and Research Clinical Rheumatology Low back pain Fijacko 39 Journal of Medical Systems a Type 2 Diabetes Lee 40 British Journal of Sports Medicine Concussion Wurzer 41 Burns Burns Vega 42 PLOS One Pain Wallace 43 Journal of Opioid Management Chronic Pain El-Gayar 44 Journal of Diabetes Science and Technology Diabetes a Journals listed in field of 'Medical Informatics' in InCites Journal Citation Reports (Clarivate Analytics, 45 or published in subsidiary journal of JMIR.…”

Section: A Priori Review Registration and Registration Guidelinementioning

confidence: 99%

Issues in reporting of systematic review methods in health app-focused reviews: A scoping review

Grainger

Devan

Sangelaji³

et al. 2020

Health Informatics J

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No guidelines exist for the conduct and reporting of manuscripts with systematic searches of app stores for, and then appraisal of, mobile health apps (‘health app-focused reviews’). We undertook a scoping review including a systematic literature search for health app-focused reviews describing systematic app store searches and app appraisal, for apps designed for patients or clinicians. We created a data extraction template which adapted data elements from the PRISMA guidelines for systematic literature reviews to data elements operationalised for health app-focused reviews. We extracted the data from included health app-focused reviews to describe: (1) which elements of the adapted ‘usual’ methods of systematic review are used; (2) methods of app appraisal; and (3) reporting of clinical efficacy and recommendations for app use. From 2798 records, the 26 included health app-focused reviews showed incomplete or unclear reporting of review protocol registration; use of reporting guidelines; processes of screening apps; data extraction; and appraisal tools. Reporting of clinical efficacy of apps or recommendations for app use were infrequent. The reporting of methods in health app-focused reviews is variable and could be improved by developing a consensus reporting standard for health app-focused reviews.

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mHealth technologies for osteoarthritis self-management and treatment: A systematic review

Cited by 52 publications

References 45 publications

Co-Design in the Development of a Mobile Health App for the Management of Knee Osteoarthritis by Patients and Physicians: Qualitative Study

Co-Design in the Development of a Mobile Health App for the Management of Knee Osteoarthritis by Patients and Physicians: Qualitative Study

Implementing Systematically Collected User Feedback to Increase User Retention in a Mobile App for Self-Management of Low Back Pain: Retrospective Cohort Study

Issues in reporting of systematic review methods in health app-focused reviews: A scoping review

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