Smartphone Apps Targeting Physical Activity in People With Rheumatoid Arthritis: Systematic Quality Appraisal and Content Analysis

Bearne, Lindsay; Sekhon, Mandeep; Grainger, Rebecca; La, Anthony; Shamali, Mehrdad; Amirova, Aliya; Godfrey, Emma; White, Claire

doi:10.2196/18495

Cited by 29 publications

(27 citation statements)

References 42 publications

(75 reference statements)

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“…It was used in 38% (15/39) of papers as the sole means of quality evaluation [ 45 - 49 , 52 , 57 , 69 - 71 , 73 - 76 , 78 , 79 ]. MARS was also used in an additional 23% of papers along with other methodologies, such as clinical guidelines [ 46 , 55 , 56 , 58 , 65 , 67 , 68 , 77 , 81 ]. The breakdown of methodologies and the frequency of their use can be viewed in Table 3 .…”

Section: Resultsmentioning

confidence: 99%

Identification and Evaluation of Methodologies to Assess the Quality of Mobile Health Apps in High-, Low-, and Middle-Income Countries: Rapid Review

Woulfe¹,

Fadahunsi²,

Smith³

et al. 2021

JMIR Mhealth Uhealth

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Background In recent years, there has been rapid growth in the availability and use of mobile health (mHealth) apps around the world. A consensus regarding an accepted standard to assess the quality of such apps has yet to be reached. A factor that exacerbates the challenge of mHealth app quality assessment is variations in the interpretation of quality and its subdimensions. Consequently, it has become increasingly difficult for health care professionals worldwide to distinguish apps of high quality from those of lower quality. This exposes both patients and health care professionals to unnecessary risks. Despite progress, limited understanding of the contributions of researchers in low- and middle-income countries (LMICs) exists on this topic. Furthermore, the applicability of quality assessment methodologies in LMIC settings remains relatively unexplored. Objective This rapid review aims to identify current methodologies in the literature to assess the quality of mHealth apps, understand what aspects of quality these methodologies address, determine what input has been made by authors from LMICs, and examine the applicability of such methodologies in LMICs. Methods This review was registered with PROSPERO (International Prospective Register of Systematic Reviews). A search of PubMed, EMBASE, Web of Science, and Scopus was performed for papers related to mHealth app quality assessment methodologies, which were published in English between 2005 and 2020. By taking a rapid review approach, a thematic and descriptive analysis of the papers was performed. Results Electronic database searches identified 841 papers. After the screening process, 52 papers remained for inclusion. Of the 52 papers, 5 (10%) proposed novel methodologies that could be used to evaluate mHealth apps of diverse medical areas of interest, 8 (15%) proposed methodologies that could be used to assess apps concerned with a specific medical focus, and 39 (75%) used methodologies developed by other published authors to evaluate the quality of various groups of mHealth apps. The authors in 6% (3/52) of papers were solely affiliated to institutes in LMICs. A further 15% (8/52) of papers had at least one coauthor affiliated to an institute in an LMIC. Conclusions Quality assessment of mHealth apps is complex in nature and at times subjective. Despite growing research on this topic, to date, an all-encompassing appropriate means for evaluating the quality of mHealth apps does not exist. There has been engagement with authors affiliated to institutes across LMICs; however, limited consideration of current generic methodologies for application in LMIC settings has been identified. Trial Registration PROSPERO CRD42020205149; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=205149

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Section: Resultsmentioning

confidence: 99%

Identification and Evaluation of Methodologies to Assess the Quality of Mobile Health Apps in High-, Low-, and Middle-Income Countries: Rapid Review

Woulfe¹,

Fadahunsi²,

Smith³

et al. 2021

JMIR Mhealth Uhealth

View full text Add to dashboard Cite

show abstract

“…Despite the availability of validated tools for assessing the quality of apps, such as the Mobile App Rating Scale [ 26 ], there is minimal agreement on methods and the most appropriate criteria for this task [ 19 ]. Besides, few IMID-related apps have been developed or validated using these methodologies [ 14 , 27 , 28 ]. Author affiliation is an important characteristic when searching for a trustworthy app and has been a quality criterion in numerous studies [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

The Characteristics and Functionalities of Mobile Apps Aimed at Patients Diagnosed With Immune-Mediated Inflammatory Diseases: Systematic App Search

et al. 2022

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Background Immune-mediated inflammatory diseases (IMIDs) are systemic conditions associated with a high social and health impact. New treatments have changed the prognosis of IMIDs and have increased patient autonomy in disease management. Mobile apps have enormous potential to improve health outcomes in patients with IMIDs. Although a large number of IMID apps are available, the app market is not regulated, and functionality and reliability remain uncertain. Objective Our aims are to review available apps for patients with IMIDs or caregivers and to describe the main characteristics and functionalities of these apps. Methods We performed an observational, cross-sectional, descriptive study of all apps for patients with IMIDs. Between April 5 and 14, 2021, we conducted a search of the App Store (iOS) and Play Store (Android) platforms. We used the names of the different IMIDs as search terms. The inclusion criteria were as follows: content related to IMIDs, English or Spanish language, and user population consisting of patients and health care consumers, including family and caregivers. The variables analyzed were as follows: app name, type of IMID, platform (Android or iOS), country of origin, language, category of the app, cost, date of the last update, size, downloads, author affiliation, and functionalities. Results We identified 713 apps in the initial search, and 243 apps met the criteria and were analyzed. Of these, 37% (n=90) were on Android, 27.2% (n=66) on iOS, and 35.8% (n=87) on both platforms. The most frequent categories were health and well-being/fitness apps (n=188, 48.5%) and medicine (n=82, 37.9%). A total of 211 (82.3%) apps were free. The mean time between the date of the analysis and the date of the most recent update was 18.5 (SD 19.3) months. Health care professionals were involved in the development of 100 (41.1%) apps. We found differences between Android and iOS in the mean time since the last update (16.2, SD 14.7 months vs 30.3, SD 25.7 months) and free apps (85.6% vs 75.8%; respectively). The functionalities were as follows: general information about lifestyles, nutrition, or exercises (n=135, 55.6%); specific information about the disease or treatment (n=102, 42%); recording of symptoms or adverse events (n=51, 21%); agenda/calendar (n=44, 18.1%); reminder medication (n=41, 16.9%); and recording of patient-reported outcomes (n=41, 16.9%). A total of 147 (60.5%) apps had more than one functionality. Conclusions IMID-related apps are heterogeneous in terms of functionality and reliability. Apps may be a useful complement to IMID care, especially inpatient education (their most frequent functionality). However, more than half of the IMID apps had not been developed by health care professionals or updated in the last year.

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“…Surprisingly, our review did not include any studies that investigated mobile applications to support adherence to PA. Mobile apps that aim to support adherence to PA are available for people with inflammatory arthritis conditions [ 50–54 ], although app content and quality are heterogeneous, and integrated measures to assess PA are often not evidence based [ 23 ]. A recent review identified one high-quality mobile app that was designed for people with RA, although its effectiveness has not been established [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of web-based and mobile health interventions designed to enhance adherence to physical activity for people with inflammatory arthritis: a systematic review

Sekhon

White

Godfrey

et al. 2021

Rheumatology Advances in Practice

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Objective The aim of this systematic review was to assess the evidence from randomised controlled trials (RCT) and cohort studies for the effectiveness of digital interventions designed to enhance adherence to physical activity (PA) for people with inflammatory arthritis (IA) and describe the intervention content using established coding criteria. Methods Six electronic databases were searched for published and unpublished studies. Independent data extraction and quality assessment (Cochrane risk of bias II or ROBIN I) were conducted by two reviewers. The primary outcome was self-reported adherence to PA post-intervention. Secondary outcomes included self-reported adherence to PA at other timepoints, level of PA or engagement with intervention at any follow-up timepoint. Intervention content was assessed using the Consensus on Exercise Reporting Template and the Behaviour Change Techniques taxonomy version 1. Results From 11,136 reports, four moderate risk of bias studies (three RCTs, one cohort study) including 1,160 participants with rheumatoid arthritis or juvenile inflammatory arthritis were identified. Due to heterogeneity of outcomes, a narrative synthesis was conducted. Only one RCT reported a small between group difference in adherence to PA [mean difference (95% confidence intervals) -0.46 (-0.82. -0.09)] in favour of the intervention. There were no between group differences in any secondary outcomes. Interventions included between 3–11 behaviour change techniques but provided minimal exercise prescription information. Conclusion There is currently limited moderate quality evidence available to confidently evaluate the effect of web-based and mobile health interventions on adherence to PA or level of PA post intervention in people with IA.

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Smartphone Apps Targeting Physical Activity in People With Rheumatoid Arthritis: Systematic Quality Appraisal and Content Analysis

Cited by 29 publications

References 42 publications

Identification and Evaluation of Methodologies to Assess the Quality of Mobile Health Apps in High-, Low-, and Middle-Income Countries: Rapid Review

Identification and Evaluation of Methodologies to Assess the Quality of Mobile Health Apps in High-, Low-, and Middle-Income Countries: Rapid Review

The Characteristics and Functionalities of Mobile Apps Aimed at Patients Diagnosed With Immune-Mediated Inflammatory Diseases: Systematic App Search

Effectiveness of web-based and mobile health interventions designed to enhance adherence to physical activity for people with inflammatory arthritis: a systematic review

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