Background: Hand osteoarthritis (OA) is a prevalent joint disease, with a lifetime risk of 50% in women and 25 % in men. The recommended core treatment for hand OA includes patient education, hand exercises, and the use of assistive devices. However, access to this treatment is often limited. Self-management is an essential component in the treatment of hand OA, yet implementing a systematic and reliable approach to support self-management for people with hand OA remains a challenge. Digital devices, such as smartphone apps, can be used to deliver self-management interventions and help individuals adhere to them. The Happy Hands app consists of a 12-week self-management intervention comprising 25 short informational videos and a hand exercise program with 8 videos providing instructions on warm up, exercises to improve mobility, strength and coordination, and a stretching exercise. Participants select three days a week, along with time slots, to use the app. On these designated days they receive notifications on their smartphone with that week’s informational videos and hand exercises. Encouragement, motivational messages and quizzes are provided each week to enhance continued adherence to the intervention.

Objectives: The aim of this qualitative study was to explore how people with hand osteoarthritis experience using the Happy Hands app.

Methods: The study is part of a larger RCT investigating the effect and cost-effectiveness of an e-self-management intervention for people with hand OA, delivered through the Happy Hands app. Data collection included seven focus group discussions. The participants in the focus groups were recruited from the intervention group in the RCT. A semi-structured interview guide including questions focusing on the participants experiences, perceptions and challenges, was used. The focus groups were audio recorded, transcribed verbatim and analysed using reflexive thematic analysis.

Results: A total of 26 participants were recruited from both specialist and primary healthcare in all four health regions in Norway. The median age was 66 years, and most of the participants were women (n=18). Three themes were developed through the analysis: Changed perception of hand osteoarthritis: Throughout the self-management intervention delivered through the app, participants gained knowledge and insights about hand OA which changed their perception of the disease. Understanding the disease and its mechanisms reduced feelings of uncertainty, for example by getting an understanding of why they had pain and why some activities suddenly were difficult to perform. Information in the app empowered them to make informed decisions about their care based on updated knowledge. Participants also described that the app gave them hope and motivation by demonstrating that different measures could be taken to manage the disease effectively. Changing habits with the Happy Hands app: The participants expressed satisfaction with the app, and the exercise program in the app was experienced as motivating, flexible and well-structured. However, some challenges were described, including experiencing pain during or after exercising. Some participants felt that their hand OA was too advanced for effective exercise, and not all reported experiencing improvement. It was suggested to include guidance on managing pain during exercise. The results suggest that the Happy Hands app enabled participants to implement and learn an exercise program for hand OA, and to integrate exercising into their daily life, thus making exercising a habit. The participants also changed performance of everyday activities, including ergonomic working methods and use of assistive devices as suggested in the app. Experience of improvement, such as less pain, better grip strength and being able to perform activities which previously had been challenging, motivated participants to continue to carry out the exercise program. Being acknowledged: Participants described a sense of lacking support and recognition for their hand OA from family members, health care providers and the society at large. Being part of the project and getting access to the app were therefore perceived as meaningful, as these experiences provided a sense of validation and acknowledgment. Participants conveyed the feeling that their condition and well-being truly mattered.

Conclusion: This study contributes to existing knowledge about individuals’ experience with self-management interventions delivered through a digital application. The results reveal that participants developed new habits after completing the intervention; including incorporating hand exercising into their daily routines and adjusting activity performance. Using the app further enhanced their understanding of hand OA and provided a sense of acknowledgement. Overall, the results suggest that participants benefited from completing this e-self-management intervention for hand OA.

REFERENCES: NIL.

Acknowledgements: NIL.

Disclosure of Interests: None declared.

© The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.