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Modern technologies offer the possibility of 24\/7\u00a0self-management support. We developed an e-self-management application (dr. Bart app) for people with knee\/hip OA.<\/jats:p>\n                <jats:p>The aim of this study was to document the use and usability of the dr. Bart app and its relation with health care utilisation and clinical outcomes in people with knee\/hip OA.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>For this study we used backend data for the first 26\u2009weeks of use by the intervention group (<jats:italic>N<\/jats:italic>\u2009=\u2009214) of an RCT examining the effectiveness of the dr. Bart app. A central element of the dr. Bart app is that it proposes a selection of 72 preformulated goals for health behaviours based on the \u2018tiny habits method\u2019 (e.g. after lunch I rise 12 times from my chair to train my leg muscles). The usability of the app was measured using the System Usability Scale questionnaire (SUS), on a scale of 0\u2013100. To assess the association between the intensity of use of the app and health care utilisation (i.e., consultations in primary or secondary health care) and clinical outcomes (i.e., self-management behaviour, physical activity, health-related quality of life, illness perceptions, symptoms, pain, activities of daily living) we calculated Spearman rank correlation coefficients.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Of the 214 participants, 171 (80%) logged in at least once with 151 (71%) choosing at least one goal and 114 (53%) completing at least one goal during the 26\u2009weeks. Of those who chose at least one goal, 56 participants (37%) continued to log in for up to 26\u2009weeks, 12 (8%) continued to select new goals from the offered goals and 37 (25%) continued to complete goals. Preformulated goals in the themes of physical\u00a0activity (e.g., performing an exercise from the exercises library in the app) and nutrition (e.g., \u2018eat two pieces of fruit today\u2019) were found to be most popular with users. The mean usability scores (standard deviation) at the three and six month follow-ups were 65.9 (16.9) and 64.5 (17.5), respectively. The vast majority of associations between the intensity of use of the dr. Bart app and target outcomes were weak at \u03c1\u2009&lt;\u2009(\u2212) 0.25.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>More than one-third of people with knee\/hip OA who started using the app, continued to use it up to 26\u2009weeks, though usability could be improved. Patients appear to have preferences for goals related to physical\u00a0activity and nutrition, rather than for goals related to vitality and education. We found weak\/no associations between the intensity of use of the dr. Bart app and health care utilisation and clinical outcomes.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Trial registration<\/jats:title>\n                <jats:p><jats:bold>(21 September 2017):<\/jats:bold> Dutch Trial Register (Trial Number <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.trialregister.nl\/trial\/6505\">NTR6693\/NL6505<\/jats:ext-link>)<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12913-021-06440-1","type":"journal-article","created":{"date-parts":[[2021,5,10]],"date-time":"2021-05-10T13:18:52Z","timestamp":1620652732000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Use and usability of the dr. 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The study fell outside the remit of the law for Medical Research Involving Human Subjects Act and was approved by the local ethical committee. This study is registered in the Dutch trial register (trial number: NTR 6693) as of 21 September 2017. All participants gave digital (written) consent to participate in the present study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Frank de Graaf receives salary from Orikami B.V., the organisation that helped to develop the dr. Bart app. All other authors declare they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"444"}}