Development of an Application for Self-Monitoring to Empower Patients With Rheumatoid Arthritis (MyRA)

Objective. To develop a web-based self-monitoring tool including motivational elements to improve empowerment of patients with rheumatoid arthritis (RA).

Methods. Following a design-thinking approach, the development included 3 iterative, cocreative phases involving different stakeholders. In the empathize and define phase, 2 focus groups gave insight into patients’ wishes and needs regarding self-monitoring with an application. During the ideation phase, 2 cocreation sessions were organized to establish the content of the application and consider motivational elements. For the prototyping and testing phase, usability was assessed through both formative (heuristics evaluation) and summative (system usability scale [SUS] 0-100; ≥ 68 was considered good to excellent) evaluations.

Results. The focus group meetings resulted in a shortlist of what to monitor (physical function, quality of life, pain, fatigue, mental well-being, and social participation) and preferences on how to monitor (single-item questions, 0-10 scale, use as needed). The cocreation sessions revealed preference for empathetic dialogues with an avatar for self-monitoring. Setting goals, adding notes, sharing results, and receiving tips could further increase motivation for use. Initial experiences regarding heuristics of the tool were generally positive and confirmed by a mean SUS score of 84.4 (SD 11.6). Points for improvement included simplifying login procedures, adding notifications, and adjusting the avatar’s tone of voice.

Conclusion. A web-based self-monitoring application (MyRA) was developed, with an avatar that asks patients through dialogues to score 6 domains, with graphical displays, diary functionality, and practical tips. Further studies are needed to confirm its usability and effectiveness in empowering patients.