Understanding patient needs and preferences for joint protection in hand osteoarthritis through mixed methods patient co-design

Hand osteoarthritis (HOA) is a prevalent chronic condition that impairs quality of life and daily functioning. While joint protection programs (JPPs) offer symptom management, they remain outdated, inaccessible, and poorly tailored to patient needs. This study leverages patient co-design to develop a novel, inclusive, technology-enabled JPP. Using an explanatory sequential design, a survey of 196 participants (88% female, mean age 66 ± 8 years) identified priority activities and challenges for patients with HOA. Key activities of daily living and occupational and functional tasks were rated using a 5-point Likert scale, with a Relative Importance Index (RII) calculated for each item. Qualitative semi-structured interviews with 20 purposefully sampled participants provided in-depth insights into lived experiences with HOA and preferences in JPPs. Quantitative analysis identified high-importance tasks, such as buttoning, gripping, and twisting, with RII scores exceeding 0.8, indicating strong positive sentiment. Functional impairments included issues with precision grip and gross motor tasks, and pain interference disrupted daily activities and social roles. Qualitative themes revealed the importance of strategies for sustaining meaningful activities, patient support communities, and barriers related to accessibility, including technological literacy and caregiving responsibilities. Findings emphasize the importance of co-designing JPPs that address functional impairments, incorporate patient support communities, and consider intersectional barriers. This approach fosters accessibility, adherence, and relevance, paving the way for improved outcomes in patients with HOA.