Table 4.
Implementation of the main non-drug recommendations for patients with inflammatory arthritis in Mida Rheuma App
| Recommendation | Objective of the App | Implementation |
|---|---|---|
| 2021 EULAR recommendations regarding lifestyle behaviours and work participation to prevent progression of rheumatic and musculoskeletal diseases [68] | ||
| Overarching principles (1–5) | To reduce disease activity, improve HRQoL and physical function of patients | Fully implemented. All lifestyle recommendations complement medical treatment and depend on patients’ individual characteristics. Contact with the doctor is enabled |
| Exercise (1–7) | To improve the overall health of patients by optimizing physical activity | Implemented all except 6th (favouring group exercises). Both aerobic and strengthening exercises are recommended with special attention to patients with SpA |
| Diet (1–2) | To reduce inflammation by changing the patient's eating behavior | Fully implemented. A healthy, balanced diet is recommended as a separate program depending on patient needs |
| Alcohol (1–3; 4–NA, gout only) | To reduce inflammation by changing the patient's alcohol behavior | Fully implemented. Recommendations are based on explaining the impact of different doses of alcohol on the course of arthritis and providing advice for reducing the dose in patients who need it based on an assessment of individual alcohol consumption |
| Weight (1–2) | To improve the functional state of patients by normalizing weight for overweight patients | Fully implemented. Patients are involved in the process of achieving and maintaining a healthy weight using a specific program for this purpose, in addition to exercise and dietary advice |
| Smoking (1–2) | To improve disease activity by encouraging patients to stop smoking | Fully implemented. Patients are educated on the effects of smoking on their disease and symptoms. They are supported in stopping to smoke using a specific program for this purpose |
| Work (1) | To improve the overall health of patients by optimizing work activity | Fully implemented. Recommendations are based on the involvement of the patient in the work and ways to optimize it in accordance with the patient's condition |
| 2021 EULAR recommendations for the implementation of self-management strategies in patients with inflammatory arthritis [6] | ||
| Overarching principles (A-B; C–NA, for patient organisations only) | To improve self-efficacy of the patients by changing self-management behaviors | Fully implemented. Evaluation and recommendations related to self-efficacy are implemented as a separate program |
| Recommendations (2–3, 5–6, 8; 1, 4, 7, 9–NA, for healthcare professionals only) | Fully implemented. Evidence-based self-management program includes education, cognitive behavioural therapy, promotion of physical activity, and mental health recommendations | |
| EULAR recommendations for patient education for people with inflammatory arthritis [69] | ||
| Overarching principles (1–2) | To increase the efficiency and safety of patient treatment through additional education | Fully implemented. Education in the application is set up as an interactive learning process. Contact with the doctor is enabled |
| Recommendations (1–6; 7, 8–NA, for healthcare professionals only) | Fully implemented. Patients have access to evidence-based education throughout the course of their disease in a needs-based manner. The effectiveness of education is evaluated. Online interactions are enabled | |
| EULAR points to consider for the development, evaluation and implementation of mobile health applications aiding self-management in people living with rheumatic and musculoskeletal diseases [30] | ||
| Points to consider (1–8, 9–NA,10) | To optimize the process of developing and adapting the application, considering proven effective development approaches | Implemented all except 10th. The information content is up to date, scientifically justifiable, user acceptable and tailored to the individual needs of patients (1, 2). Design development and adaptation was carried out with the participation of patients with RA and SpA and rheumatologists taking into account adaptation for use by patients with impaired hand function (3, 8). All data regarding the developer and funding sources are open (4). Data collection adheres to all applicable regulatory frameworks, such as the European General Data Protection Regulation and the German Federal Data Protection Act (5). The content of the information for patients is aimed at motivating relatively long-term positive behaviour change and improving interaction with the attending physician, the risks and benefits of use are assessed, and actions are taken to minimize them (6, 7). Evaluation of cost–benefit balance (10) is planned |
NA not applicable