Mobile Apps in Rheumatology: Review and Analysis Using the Mobile App Rating Scale (MARS)

Johannes Knitza¹, Koray Tascilar ², Eva-Maria Messner ³, Marco Meyer ⁴, Diana Vossen ⁵, Almut Pulla ⁶, Philipp Bosch ⁷, Julia Kittler ⁸, Arnd Kleyer ¹, Philipp Sewerin ⁹, Johanna Mucke ¹⁰, Isabell Haase ¹¹, David Simon ¹² and Martin Krusche ¹³, ¹Department of Internal Medicine 3 – Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg, University Hospital Erlangen, Erlangen, Germany, Erlangen, Germany, ²Department of Internal Medicine 3 – Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg, University Hospital Erlangen, Erlangen, Germany, Erlangen, Bayern, Germany, ³Department for Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany, Ulm, Germany, ⁴Asklepios Klinik Altona, Rheumatologie, Klinische Immunologie, Nephrologie, Hamburg, Germany; German Society for Rheumatology (Working Group Young Rheumatology), Hamburg, Germany, ⁵Departement for Internal Medicine and Rheumatology, Rheinisches Rheumazentrum Meerbusch, St. Elisabeth-Hospital, Meerbusch, Germany; German Society for Rheumatology (Working Group Young Rheumatology), Meerbusch, Germany, ⁶Rheinisches Rheumazentrum Meerbusch, St. Elisabeth-Hospital, Meerbusch, Germany; German Society for Rheumatology (Working Group Young Rheumatology), Meerbusch, Germany, ⁷Department of Rheumatology and Immunology, Medical University Graz, Graz, Austria, Graz, Austria, ⁸Department of Internal Medicine 3 – Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg, University Hospital Erlangen, Erlangen, Germany; German Society for Rheumatology (Working Group Young Rheumatology), Erlangen, Germany, ⁹Department of Rheumatology & Hiller Research Unit, University Hospital Düsseldorf,, Duesseldorf, Germany, ¹⁰Department and Hiller Research Unit of Rheumatology, Heinrich-Heine University Duesseldorf, Düsseldorf, Germany, ¹¹Policlinic for Rheumatology & Hiller Research Centre for Rheumatology, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany, ¹²Department of Internal Medicine 3, Friedrich-Alexander-University Erlangen-Nuremberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Bayern, Germany, ¹³Department of Rheumatology and Clinical Immunology, Charité-Universitätsmedizin, Berlin, Germany; German Society for Rheumatology (Working Group Young Rheumatology), Berlin, Germany

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: medication and patient engagement, MHealth, patient-reported outcome measures

Session Information

Date: Monday, November 11, 2019

Session Title: Health Services Research Poster II – ACR/ARP

Session Type: Poster Session (Monday)

Session Time: 9:00AM-11:00AM

Background/Purpose: Mobile applications promise to facilitate the life of patients as well as physicians. In routine practice, however, rheumatology apps are largely unknown and little is known about their quality and safety. The aim of this study was to provide an overview of the mobile rheumatology applications currently available in the German App Stores, to evaluate the app quality using the Mobile App Rating Scale (MARS) and compile brief, ready to-use descriptions for patients as well as rheumatologists.

Methods: The German Google Play and Apple App Stores were systematically searched to identify German Rheumatology mobile applications addressing patients as well as physicians. App quality was assessed independently using MARS by in total 8 physicians, 4 using Android and 4 using iOS smartphones. The MARS score is based on a 5-point Likert scale in four sections with multiple items: engagement (5 items), functionality (4 items), aesthetics (3 items), and information quality (7 items). In addition, there is a “subjective” section consisting of 4 items. Apps were randomly assigned so that 4 apps were rated by all raters and the remaining apps were rated by two Android and two iOS users. Furthermore, brief app descriptions including app developers, app categories and features were compiled to inform potential users and developers.

Results: In total 128 and 63 apps were identified in the German Google Play and Apple App Stores, respectively. After removing doublets and only including apps that were available in both stores 28 apps remained, of which 16 final apps met the inclusion criteria, which were: (1) German language; (2) availability in both app stores; (3) targeting patients or physicians as users, and (4) clearly including rheumatology or rheumatic diseases as subject matter. Exclusion criteria were: (1) congress apps (2) company apps with advertisements. 9 apps addressed patients, 7 apps addressed physicians. No clinical studies to support the effectiveness and safety of these apps could be found. Pharmaceutical companies were the main developers of two apps. Rheuma-Auszeit, was the only app mainly developed by a patient organization. This app, had the highest overall MARS score (4.19/5). 3/9 patient apps featured validated questionnaires. The median overall MARS score was 3.85/5 ranging from 2.81/5 to 4.19/5. One patient targeted app and one physician targeted app had a MARS score >4/5. No significant gender or platform (iOS/Android) differences could be observed.

Conclusion: This is the first study, which systematically identified and evaluated mobile applications in rheumatology for patients as well as physicians available in German App Stores. We found a lack of supporting clinical studies, use of validated questionnaires and involvement of academic developers. Overall app quality was very heterogeneous. To create high-quality apps a closer cooperation lead by patients and physicians is vital.

Disclosure: J. Knitza, None; K. Tascilar, None; E. Messner, None; M. Meyer, None; D. Vossen, None; A. Pulla, None; P. Bosch, None; J. Kittler, None; A. Kleyer, None; P. Sewerin, AbbVie, 2, 5, 8, Biogen, 5, 8, BMS, 5, 8, Celgene, 2, 5, 8, Chugai, 2, 5, 8, Hexal, 5, 8, Janssen-Cilag, 2, 5, 8, Lilly, 2, 5, 8, Novartis, 2, 5, 8, Pfizer, 2, 5, 8, Roche, 5, 8, Sanofi-Genzyme, 5, 8, Swedish Orphan Biovitrum, 5, 8, UCB, 2, 5, 8; J. Mucke, None; I. Haase, None; D. Simon, None; M. Krusche, None.

To cite this abstract in AMA style:

Knitza J, Tascilar K, Messner E, Meyer M, Vossen D, Pulla A, Bosch P, Kittler J, Kleyer A, Sewerin P, Mucke J, Haase I, Simon D, Krusche M. Mobile Apps in Rheumatology: Review and Analysis Using the Mobile App Rating Scale (MARS) [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/mobile-apps-in-rheumatology-review-and-analysis-using-the-mobile-app-rating-scale-mars/. Accessed January 27, 2023.

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