AzTrials
AzTrials

Hand OsteoarthritisHappyHandsNCT05568875

Happy Hands - an E-self-management Intervention for People With Hand Osteoarthritis

A study testing e-self-management intervention (Happy Hands app) and Treatment as usual in people with Hand Osteoarthritis, run by Diakonhjemmet Hospital at 19 sites in Norway.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

The main aim of this project is to assess the effect, cost-effectiveness and user experiences with using an e-self-management intervention in addition to treatment as usual compared to treatment as usual alone in patients with hand osteoarthritis. Read more about this study

Who is it for?
Ages 40 years and older
Conditions the study is for
Hand Osteoarthritis
What is being tested?
e-self-management intervention (Happy Hands app) and Treatment as usual
Could I receive a placebo?
No, everyone receives an active treatment
How many people
386 participants
Where
19 sitesNorway
Study dates
8 Nov 2022to 29 Feb 2024
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 40 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • People diagnosed with hand osteoarthritis
  • Possessing a smartphone

Who cannot join

  • cognitive deficits
  • are scheduled for hand surgery within the next 3 months
  • do not talk or understand Norwegian,
  • have uncontrolled serious comorbidities

Trial locations and contacts

19 sites in 1 country.

19 sites in 1 country

Norway19 sites
  • Ålesund sjukehus

    Ålesund

  • Arendal sykehus

    Arendal

  • Haukeland Universitetssykehus

    Bergen

  • Aurskog Fysikalske Institutt

    Bjørkelangen

  • Nordlandssykehuset

    Bodø

  • Lærdal Sjukehus

    Førde

  • Finnmarkssykehuset, Kirkenes Sykehus

    Kirkenes

  • Kongsvinger sykehus

    Kongsvinger

  • Kristiansand sykehus

    Kristiansand

  • Levanger sykehus

    Levanger

  • Revmatismesykehuset Lillehammer

    Lillehammer

  • Meråker kurbad

    Meråker

  • Nøtterøy Fysioterapi

    Nøtterøy

  • Diakonhjemmet Hospital

    Oslo

  • Humana Helse

    Sandvika

  • Helsehuset Stokke

    Tønsberg

  • Universitetssykehuset Nord-Norge

    Tromsø

  • St.Olavs Hospital

    Trondheim

  • Vikersund bad

    Vikersund

Other trials in Norway

About this study

The main aim of this project is to assess the effect, cost-effectiveness and user experiences with using an e-self-management intervention in addition to treatment as usual compared to treatment as usual alone in patients with hand osteoarthritis. The study is an RCT comprising approx 400 participants with hand osteoarthritis recruited from primary and secondary healthcare in all four health regions in Norway.

Read the detailed description

Hand osteoarthritis (OA) is a highly prevalent rheumatic joint disease, and the number of people living with debilitating hand OA will continue to rise in the coming decades due to increased life expectancy. Research shows that patients with hand OA have poor access to recommended treatment, and in Norway, they are increasingly referred to surgical consultation before having received recommended first-line treatment. Thus, there is a need to develop easily viable models of care for patients with hand OA that make recommended treatment available across different healthcare levels.

Our hypotheses are that an e-self-management intervention for people with hand OA will improve pain and function and be more cost-effective compared to treatment as usual, and that this app can easily be implemented in both specialist and primary healthcare. The hypotheses will be tested and explored in a randomized controlled trial, with a qualitative study nested within this trial.

The main research questions are:

  1. To evaluate whether a 12-week e-self-management intervention is more effective in improving pain and function (according to the OMERACT-OARSI responder criteria26) compared to usual care in patients with hand OA (randomized controlled trial).
  2. To determine the cost-effectiveness of the e-self-management intervention compared to usual care after 6 months (randomized controlled trial).
  3. To explore patients' experience of barriers and facilitators for adopted and continued use of a e-self-management intervention for treatment of hand OA (qualitative interviews).

Secondary research questions will also be assessed.

Approx 400 patients will be recruited in this multicenter randomized controlled trial where patients with hand OA are allocated to either usual care or a 12-week e-self-management intervention delivered through a smartphone app (the HAPPY Hands app). Outcome measures are collected at baseline, 3 months (=end of intervention) and 6 months

Being tested
e-self-management intervention (Happy Hands app), Treatment as usual

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • e-self-management intervention (Happy Hands app)Other

    The 12-week intervention consists of 30 short informational videos addressing the themes prioritized by the patient research partners. These themes are further operationalized into the following categories: "Information on hand OA", "Hand exercises", "Use of assistive devices and orthoses", "Medication and surgical alternatives", and "Self-management of the disease". Additionally, the intervention includes a hand exercise program consisting of 8 videos providing instructions on warm up, exercises to improve mobility, strength and coordination, and a stretching exercise. The intervention group will additionally receive treatment as usual.

  • Treatment as usualOther

    Treatment as usual may vary from no treatment at all to referral to a patient education group program, or occupational therapy.

Study groups in NCT05568875
Study groupRoleWhat they receive
e-self-management interventionExperimental12-week e-self-management intervention consisting of exercise videos and videos with information about recommended treatment
Receives: Other: e-self-management intervention (Happy Hands app); Other: Treatment as usual
Treatment as usualActive comparatorTreatment as usual
Receives: Other: Treatment as usual

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. OMERACT/OARSI responder criteria

    Combined score of change in pain, function and disease activity. Patients are categorized into responders or non-responders according to the following:

    High improvement on pain or function:

    1. ≥50% improvement + absolute change of ≥2 in pain (numeric rating scale, NRS 0-10), OR
    2. ≥50% improvement + absolute change of ≥0.6 in function (Measure of Activity Performance of the Hand, MAP-Hand)

    Improvement in at least two of the three following:

    1. ≥20% improvement + absolute change of ≥1 in pain (NRS)
    2. ≥20% improvement + absolute change of ≥0.3 in function (MAP-Hand)
    3. ≥20% improvement + absolute change of ≥1 in global assessment of disease activity (NRS)

    Measured: Baseline and 3 months follow-up

Secondary outcomes (30)
  1. OMERACT/OARSI responder criteria long-term

    Combined score of change in pain, function and disease activity. Patients are categorized into responders or non-responders according to the following:

    High improvement on pain or function:

    1. ≥50% improvement + absolute change of ≥2 in pain (numeric rating scale, NRS 0-10), OR
    2. ≥50% improvement + absolute change of ≥0.6 in function (Measure of Activity Performance of the Hand, MAP-Hand)

    Improvement in at least two of the three following:

    1. ≥20% improvement + absolute change of ≥1 in pain (NRS)
    2. ≥20% improvement + absolute change of ≥0.3 in function (MAP-Hand)
    3. ≥20% improvement + absolute change of ≥1 in global assessment of disease activity (NRS)

    Measured: 3 and 6 months follow-up

  2. Pain intensity

    Numeric rating scale (0-10), 0=no pain, 10= worst possible pain

    Measured: Baseline, 3 and 6 months follow-up

  3. Pain intensity (intervention group)

    Numeric rating scale (0-10), 0=no pain, 10= worst possible pain, measured after each exercise session

    Measured: 3 times weekly in the intervention period (12 weeks)

  4. Stiffness

    Numeric rating scale (0-10),0=no stiffness, 10= worst possible stiffness

    Measured: Baseline, 3 and 6 months follow-up

  5. Stiffness (intervention group)

    Numeric rating scale (0-10),0=no stiffness, 10= worst possible stiffness, measured after each exercise session

    Measured: 3 times weekly in the intervention period (12 weeks)

  6. Disease activity

    Numeric rating scale (0-10), 0=no disease activity; 10=high disease activity

    Measured: Baseline, 3 and 6 months follow-up

  7. Disease activity (intervention group)

    Numeric rating scale (0-10), 0=no disease activity; 10=high disease activity, measured each month in the intervention period

    Measured: Monthly in the intervention period (12 weeks)

  8. Measure of Activity performance (MAP-Hand)

    18 questions conserning activity performance of the hand (1=no problem, 4=cannot do the activity), mean score from 1-4.

    Measured: Baseline, 3 and 6 months follow-up

  9. Measure of Activity performance (MAP-Hand) (intervention group)

    18 questions conserning activity performance of the hand (1=no problem, 4=cannot do the activity), mean score from 1-4.

    Measured: Monthly in the intervention period (12 weeks)

  10. Grip strength

    Measured with Jamar dynamometer (kg), mean of two measures for each hand

    Measured: Baseline and 3 months follow-up

  11. Quality indicators for hand osteoarthritis treatment

    Quality indicators based on the OA-QI questionnaire, adopted to fit the treatment recommendations of hand osteoarthritis. 16 questions answered with yes, no or not appriopriate/do not know. Measured as pass rate.

    Measured: Baseline, 3 and 6 months follow-up

  12. eHealth literacy

    Measured with the eHEALS questionnaire, Norwegian version. 8 questions conserning eHealth literacy (strongly disagree - strongly agree)

    Measured: Baseline

  13. Number of painful joints

    Number of painful joints on left and right hand

    Measured: Baseline

  14. Change in condition

    Global rating of change scale, likert scale with 7 answer options from much better to much worse

    Measured: Baseline, 3 and 6 months follow-up

  15. Change in condition (intervention group)

    Global rating of change scale, likert scale with 7 answer options from much better to much worse

    Measured: Monthly in the intervention group (3 months)

  16. Motivation for hand exercises

    Numeric rating scale (0-10), 0=no motivation, 10=best motivation

    Measured: Baseline and 3 monhts follow-up

  17. Health-related quality of life

    Measured with EQ5D-5L, 5 questions used to calculate an utility score (0-1, 1= best health), assessed as a total score across all timepoints

    Measured: Baseline, 3 and 6 months follow-up

  18. Health care utilization

    Costs related to self-reported healthcare use in primary and secondary health care. Patients will be asked if they have been seeking healthcare (yes/no), if yes, they will be asked to specify type of healthcare use and time used.

    Measured: Baseline, 3 and 6 months follow-up

  19. Medication use

    Medication use will be self-reported by the patient

    Measured: Baseline, 3 and 6 months follow-up

  20. Adverse events

    Number of adverse events, serious adverse events, and withdrawals because of adverse events. Will be self-reported

    Measured: 3 and 6 months follow-up

  21. Sickleave

    Sickleave due to hand osteoarthritis will be self-reported

    Measured: Baseline, 3 and 6 months follow-up

  22. Fatigue

    Fatigue last week measured on an 11-point NRS (0=no fatigue, 10=worst possible fatigue)

    Measured: Baseline, 3 and 6 months follow-up

  23. Patient satisfaction with care

    1 item with five point response options ranging from "Very satisfied" to "Very dissatisfied", higher value indicate better outcome

    Measured: Baseline, 3 and 6 months follow-up

  24. System Usability Scale (SUS)

    Questionnaire assessing the usability of the Happy Hands app, 10 questions (strongly agree - strongly disagree), index from 0-100 where 100 is best score

    Measured: 3 month follow-up

  25. Adherence to exercise

    Number of exercises performed (0-36 exercise sessions), collected from the app

    Measured: 3 times weekly during the intervention period (3 months)

  26. Adherence to exercise long-term

    Number of exercises performed after completion of intervention, collected from the app

    Measured: 3 and 6 months follow-up

  27. Adherence to informational videos

    Number of informational videos watched, collected from the app

    Measured: During the intervention period (3 months)

  28. Adherence to informational videos long-term

    Number of informational videos watched, collected from the app

    Measured: 3 and 6 months follow-up

  29. Arthritis self-efficacy scale

    Measured by Arthritis Self-Efficacy Scale (ASES): comprises 11 items addressing pain and symptoms (scored on a 5-point scale ranging from not confident at all to very confident). The scores are summed up to a 0-100 score where higher score indicate better self-efficacy.

    Measured: Baseline

  30. Demographic variable

    Age, gender, other painful joints, sivil status, education, previous hand surgery, previous treatment, comorbidities

    Measured: Baseline

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted6 Oct 2022
  2. Study start8 Nov 2022
  3. Primary completion1 Sep 2023
  4. Study completion29 Feb 2024

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Multicenter randomized controlled trial with a qualitative study nested within the trial
Masking
Single blind
Who is masked
Investigator
Enrolment
386 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05568875
Sponsor's protocol ID
REK 477746
Acronym
HappyHands
Status last verified
Apr 2024
First submitted
3 Oct 2022
Last updated
13 Apr 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Individual participant data be made available when upon reasonable request to the principal investigator. The data are not available before they can be anonymoused.

Publications

  • Fjeldstad KA, Tveter AT, Rasmussen E, Olden L, Nyheim S, Blanck T, Killingmo RM, Kjeken I. Changing Habits With the Happy Hands App: Qualitative Focus Group Study of a Hand Osteoarthritis Self-Management Intervention. J Med Internet Res. 2026 Feb 2;28:e82773. doi: 10.2196/82773.

    PubMed 41628446
  • Tveter AT, Fjeldstad KA, Varsi C, Maarnes MK, Pedersen SJ, Christensen BS, Blanck T, Nyheim SB, Prior Y, Bjork M, Pelle T, Kjeken I. Evaluation of an e-self-management intervention (Happy Hands app) for hand osteoarthritis: Study protocol for a multicentre randomised controlled trial. Rheumatol Int. 2025 Jan 16;45(1):30. doi: 10.1007/s00296-025-05787-6.

    PubMed 39820549

Questions about this trial

What is this clinical trial studying?

A study testing e-self-management intervention (Happy Hands app) and Treatment as usual in people with Hand Osteoarthritis, run by Diakonhjemmet Hospital at 19 sites in Norway.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 13 Apr 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 19 sites in Norway. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

OMERACT/OARSI responder criteria (time frame: Baseline and 3 months follow-up). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05568875, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 13 Apr 2025.

Free account

Keep searching with a free account

You’ve used your 3 free searches for this session. Log in or create a free AzTrials account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in