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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
  1. Aurélie Najm1,2,
  2. Elena Nikiphorou3,
  3. Marie Kostine4,
  4. Christophe Richez4,
  5. John D Pauling5,6,
  6. Axel Finckh7,
  7. Valentin Ritschl8,9,
  8. Yeliz Prior10,11,
  9. Petra Balážová12,13,
  10. Simon Stones14,
  11. Zoltan Szekanecz15,
  12. Annamaria Iagnocco16,
  13. Sofia Ramiro17,18,
  14. Francisca Sivera19,
  15. Maxime Dougados20,
  16. Loreto Carmona21,
  17. Gerd Burmester22,
  18. Dieter Wiek23,
  19. Laure Gossec24,25 and
  20. Francis Berenbaum26,27
  1. 1 Rheumatology Department, University Hospital Centre Nantes, Nantes, France
  2. 2 INSERM UMR 1238, Universite de Nantes Ecole Doctorale Biologie-Sante, Nantes, France
  3. 3 Department of Inflammation Biology, King's College London Academic, London, UK
  4. 4 Rheumatology Department, Centre Hospitalier Universitaire de Bordeaux Groupe hospitalier Pellegrin, Bordeaux, France
  5. 5 Royal National Hospital for Rheumatic Diseases, Royal United Hospital Bath NHS Trust, Bath, UK
  6. 6 Department of Pharmacy and Pharmacology, University of Bath, Bath, UK
  7. 7 Division of Rheumatology, University Hospital of Geneva, Geneva, Switzerland
  8. 8 Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Wien, Austria
  9. 9 Division of Occupational Therapy, University of Applied Sciences, FH Campus Wien, Wien, Austria
  10. 10 Centre for Health Sciences Research, University of Salford, Salford, UK
  11. 11 Mid Cheshire NHS Foundation Trust Hospitals, Crewe, UK
  12. 12 EULAR Young PARE, Zurich, Switzerland
  13. 13 Slovak League Against Rheumatism, Piestany, Slovakia
  14. 14 School of Healthcare, University of Leeds, Leeds, UK
  15. 15 Department of Rheumatology, University of Debrecen, Faculty of Medicine, Debrecen, Hungary
  16. 16 Academic Rheumatology Centre, Università degli Studi di Torino, Torino, Italy
  17. 17 Department of Rheumatology, Zuyderland Medical Center, Heerlen, The Netherlands
  18. 18 Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
  19. 19 Rheumatology, Hospital General Universitario de Elda, Elda, Spain
  20. 20 Hopital Cochin, Rheumatology, Université Paris Descartes, Paris, France
  21. 21 Instituto de Salud Musculoesquelética, Madrid, Spain
  22. 22 Rheumatology, Charité - University Medicine Berlin, Berlin, Germany
  23. 23 Deutsche Rheuma-Liga, Bonn, Germany
  24. 24 Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM UMR S1136, Sorbonne Universite, Paris, France
  25. 25 APHP, Rheumatology Department, Hopital Universitaire Pitie Salpetriere, Paris, France
  26. 26 Rheumatology Department, AP-HP, Hopital Saint-Antoine, Paris, France
  27. 27 INSERM CRSA, Sorbonne Université, Paris, France
  1. Correspondence to Dr Aurélie Najm; aurelie.najm{at}


Background Mobile health applications (apps) are available to enable people with rheumatic and musculoskeletal diseases (RMDs) to better self-manage their health. However, guidance on the development and evaluation of such apps is lacking.

Objectives The objective of this EULAR task force was to establish points to consider (PtC) for the development, evaluation and implementation of apps for self-management of RMDs.

Methods A systematic literature review of app content and development strategies was conducted, followed by patient focus group and an online survey. Based on this information and along with task force expert opinion, PtC were formulated in a face-to-face meeting by a multidisciplinary task force panel of experts, including two patient research partners. The level of agreement among the panel in regard to each PtC was established by anonymous online voting.

Results Three overarching principles and 10 PtC were formulated. Three PtC are related to patient safety, considered as a critical issue by the panel. Three are related to relevance of the content and functionalities. The requirement for transparency around app development and funding sources, along with involvement of relevant health professionals, were also raised. Ease of app access across ages and abilities was highlighted, in addition to considering the cost benefit of apps from the outset. The level of agreement was from 8.8 to 9.9 out of 10.

Conclusion These EULAR PtC provide guidance on important aspects that should be considered for the development, evaluation and implementation of existing and new apps.

  • mobile health applications
  • self-management
  • rheumatic and musculoskeletal diseases
  • Points to consider

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

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  • LG and FB are joint senior authors.

  • Contributors AN, EN, LG and FB participated to the study design, the data analysis, the task force meeting and the manuscript redaction. All the authors contributed to the data analysis, the task force meeting and the manuscript redaction.

  • Funding This project was funded by EULAR (project number CLI102).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available on reasonable request.

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