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Additional file 1: Appendix 1. Screenshots of the dr. Bart app. Appendix 2. Baseline characteristics of participants in the study per indicator of use and non-users. Appendix 3. The 5 most and least often read paragraphs. Appendix 4. Median and interquartile range of the number of cumulative completed goals over time of the active users (n = 151). Appendix 5. Median and interquartile range of the number of cumulative logins over time of the active users (n = 151). Appendix 6. The 5 relatively most and least often completed goals (i.e., times completed / times chosen). Appendix 7. The 5 relatively most and least often chosen goals (i.e., times chosen / times proposed). Appendix 8. Some responses to the free-text option of the SUS. Appendix 9. Regression coefficient and 95% confidence interval of the relation between baseline characteristics and different parameters of use. Appendix 10. Spearman rank correlation coefficients between different indicators of use and beliefs regarding 5 treatment modalities in knee/hip OA as measured with the treatment beliefs in osteoarthritis questionnaire (TOA) (relative difference between baseline and six month follow-up).

Objective To evaluate, from a societal perspective, the cost utility and cost effectiveness of a nonpharmacologic face‐to‐face treatment program compared with a telephone‐based treatment program for patients with generalized osteoarthritis (GOA). Methods An economic evaluation was carried out alongside a randomized clinical trial involving 147 patients with GOA. Program costs were estimated from time registrations. One‐year medical and nonmedical costs were estimated using cost questionnaires. Quality‐adjusted life years (QALYs) were estimated using the EuroQol (EQ) classification system, EQ rating scale, and the Short Form 6D (SF‐6D). Daily function was measured using the Health Assessment Questionnaire (HAQ) disability index (DI). Cost and QALY/effect differences were analyzed using multilevel regression analysis and cost‐effectiveness acceptability curves. Results Medical costs of the face‐to‐face treatment and telephone‐based treatment were estimated at €387 and €252, respectively. The difference in total societal costs was nonsignificantly in favor of the face‐to‐face program (difference €708; 95% confidence interval [95% CI] −€5,058, €3,642). QALYs were similar for both groups according to the EQ, but were significantly in favor of the face‐to‐face group, according to the SF‐6D (difference 0.022 [95% CI 0.000, 0.045]). Daily function was similar according to the HAQ DI. Since both societal costs and QALYs/effects were in favor of the face‐to‐face program, the economic assessment favored this program, regardless of society's willingness to pay. There was a 65–90% chance that the face‐to‐face program had better cost utility and a 60–70% chance of being cost effective. Conclusion This economic evaluation from a societal perspective showed that a nonpharmacologic, face‐to‐face treatment program for patients with GOA was likely to be cost effective, relative to a telephone‐based program.

This dissertation studied the care needs and treatment of people with advanced osteoarthritis. It turned out that people with osteoarthritis in several joints run a higher risk of developing serious complaints in pain, physical and psychological functioning. A feasibility study into the effectiveness of a treatment showed important differences in care needs between patients. In follow-up research this should be taken into account. It was also shown that approximately 25% of the people waiting for a new joint as a consequence of osteoarthritis deteriorate in pain and functioning. This can have negative consequences for the outcomes of the operation. For these people, the usefulness of an intensive therapeutic training prior to the surgery was investigated. Literature studies show that this type of training is not useful for young, fit persons. However, fragile, elderly persons possibly benefit from such training. Particularly this last group did not participate in the feasibility study, because they could not come to the hospital. In follow-up research, therefore, the practitioner will have to visit he patients.