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van Kessel R, Ranganathan S, Anderson M, McMillan B, Mossialos E. Exploring potential drivers of patient engagement with their health data through digital platforms: A scoping review. Int J Med Inform 2024; 189:105513. [PMID: 38851132 DOI: 10.1016/j.ijmedinf.2024.105513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 04/11/2024] [Accepted: 06/02/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND Patient engagement when providing patient access to health data results from an interaction between the available tools and individual capabilities. The recent digital advancements of the healthcare field have altered the manifestation and importance of patient engagement. However, a comprehensive assessment of what factors contribute to patient engagement remain absent. In this review article, we synthesised the most frequently discussed factors that can foster patient engagement with their health data. METHODS A scoping review was conducted in MEDLINE, Embase, and Google Scholar. Relevant data were synthesized within 7 layers using a thematic analysis: (1) social and demographic factors, (2) patient ability factors, (3) patient motivation factors, (4) factors related to healthcare professionals' attitudes and skills, (5) health system factors, (6) technological factors, and (7) policy factors. RESULTS We identified 5801 academic and 200 Gy literature records, and included 292 (4.83%) in this review. Overall, 44 factors that can affect patient engagement with their health data were extracted. We extracted 6 social and demographic factors, 6 patient ability factors, 12 patient motivation factors, 7 factors related to healthcare professionals' attitudes and skills, 4 health system factors, 6 technological factors, and 3 policy factors. CONCLUSIONS Improving patient engagement with their health data enables the development of patient-centered healthcare, though it can also exacerbate existing inequities. While expanding patient access to health data is an important step towards fostering shared decision-making in healthcare and subsequently empowering patients, it is important to ensure that these developments reach all sectors of the community.
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Affiliation(s)
- Robin van Kessel
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom; Department of International Health, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands; Digital Public Health Task Force, Association of School of Public Health in the European Region (ASPHER), Brussels, Belgium.
| | | | - Michael Anderson
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom; Centre for Primary Care and Health Services Research, University of Manchester, Manchester, United Kingdom.
| | - Brian McMillan
- Centre for Primary Care and Health Services Research, University of Manchester, Manchester, United Kingdom.
| | - Elias Mossialos
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom; Institute of Global Health Innovation, Imperial College London, London, United Kingdom.
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Ghosh P, Proffitt R, Bosworth KT, Koopman RJ, Flowers L, Wilson G, Tosh AK, Braddock AS. mHealth app features that facilitate adolescent use for lifestyle management, and are endorsed by caregivers and health care providers. Mhealth 2024; 10:21. [PMID: 39114461 PMCID: PMC11304100 DOI: 10.21037/mhealth-24-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 04/27/2024] [Indexed: 08/10/2024] Open
Abstract
Background Mobile health (mHealth) apps are becoming a promising tool to motivate sustainable lifestyle and behavior changes, including modifications to diet and exercise. However, most current mHealth apps do not have meaningful, and sustained user acceptance, particularly, among adolescents. They perceive mHealth apps designed for adults to be tedious and visually unexciting, which discourage adolescent usage. Researchers and adolescent mHealth app developers would benefit from a foundational understanding of which functions and features adolescents feel would most motivate app use. Capturing caregivers' and health care providers' inputs are also important as both groups play an integral role in adolescent health care decision-making. The purpose of the study is to explore and analyze mHealth app features identified by adolescents, caregivers, and health care providers that have the potential to inspire continued use, thereby resulting in sustained health behavior changes in adolescents. Methods We used inductive thematic analysis of qualitative data obtained from semi-structured focus groups conducted via Zoom©. Important features of mHealth apps that encourage adoption and continued use were explored with 25 participants, including adolescents, their caregivers, and health care providers. Results Common features facilitating continual usage of mHealth apps that were identified as significant by participating adolescents, their caregivers and health care providers were: look and feel of the app, customization, educational information/recommendations, and integration with electronic health record. Features such as gamification and social interaction that are usually lacking in current adolescent mHealth apps were well recognized as meaningful for motivational purposes. Conclusions The findings suggest that adolescents and caregivers identify an app as valuable when it is user-friendly and intuitive and appreciate features that are motivating and can engage users in positive behaviors. Health care providers prefer mHealth apps that are user-friendly and can be effectively integrated into the cycle of care, thereby enabling delivery of efficient and value-based health care. Thus, mHealth app designs that are informed by health care providers' clinical experience and needs, in combination with app features that are desired and supported by both adolescents and their caregivers, have the potential to motivate widespread adoption and long-term use, which could result in improved health behaviors and outcomes among adolescents.
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Affiliation(s)
- Parijat Ghosh
- Department of Family and Community Medicine, School of Medicine, University of Missouri, Columbia, MO, USA
| | - Rachel Proffitt
- Department of Occupational Therapy, College of Health Sciences, University of Missouri, Columbia, MO, USA
| | - K. Taylor Bosworth
- Department of Family and Community Medicine, School of Medicine, University of Missouri, Columbia, MO, USA
- Translational Biosciences Graduate Program, School of Medicine, University of Missouri, Columbia, MO, USA
| | - Richelle J. Koopman
- Department of Family and Community Medicine, School of Medicine, University of Missouri, Columbia, MO, USA
| | - Lauren Flowers
- Department of Family and Community Medicine, School of Medicine, University of Missouri, Columbia, MO, USA
| | - Gwen Wilson
- Department of Family and Community Medicine, School of Medicine, University of Missouri, Columbia, MO, USA
| | - Aneesh K. Tosh
- Department of Child Health, School of Medicine, University of Missouri, Columbia, MO, USA
| | - Amy S. Braddock
- Department of Family and Community Medicine, School of Medicine, University of Missouri, Columbia, MO, USA
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Cheah KJ, Abdul Manaf Z, Fitri Mat Ludin A, Razalli NH, Mohd Mokhtar N, Md Ali SH. Mobile Apps for Common Noncommunicable Disease Management: Systematic Search in App Stores and Evaluation Using the Mobile App Rating Scale. JMIR Mhealth Uhealth 2024; 12:e49055. [PMID: 38532298 PMCID: PMC11004629 DOI: 10.2196/49055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 11/12/2023] [Accepted: 11/15/2023] [Indexed: 03/28/2024] Open
Abstract
Background The success of mobile apps in improving the lifestyle of patients with noncommunicable diseases through self-management interventions is contingent upon the emerging growth in this field. While users of mobile health (mHealth) apps continue to grow in number, little is known about the quality of available apps that provide self-management for common noncommunicable diseases such as diabetes, hypertension, and obesity. Objective We aimed to investigate the availability, characteristics, and quality of mHealth apps for common noncommunicable disease health management that included dietary aspects (based on the developer's description), as well as their features for promoting health outcomes and self-monitoring. Methods A systematic search of English-language apps on the Google Play Store (Google LLC) and Apple App Store (Apple Inc) was conducted between August 7, 2022, and September 13, 2022. The search terms used included weight management, obesity, diabetes, hypertension, cardiovascular diseases, stroke, and diet. The selected mHealth apps' titles and content were screened based on the description that was provided. Apps that were not designed with self-management features were excluded. We analyzed the mHealth apps by category and whether they involved health care professionals, were based on scientific testing, and had self-monitoring features. A validated and multidimensional tool, the Mobile App Rating Scale (MARS), was used to evaluate each mHealth app's quality based on a 5-point Likert scale from 1 (inadequate) to 5 (excellent). Results Overall, 42 apps were identified. Diabetes-specific mHealth apps accounted for 7% (n=3) of the market, hypertension apps for 12% (n=5), and general noncommunicable disease management apps for 21% (n=9). About 38% (n=16) of the apps were for managing chronic diseases, while 74% (n=31) were for weight management. Self-management features such as weight tracking, BMI calculators, diet tracking, and fluid intake tracking were seen in 86% (n=36) of the apps. Most mHealth apps (n=37, 88%) did not indicate whether there was involvement of health professionals in app development. Additionally, none of the apps reported scientific evidence demonstrating their efficacy in managing health. The overall mean MARS score was 3.2 of 5, with a range of 2.0 to 4.1. Functionality was the best-rated category (mean score 3.9, SD 0.5), followed by aesthetics (mean score 3.2, SD 0.9), information (mean score 3.1, SD 0.7), and engagement (mean score 2.9, SD 0.6). Conclusions The quality of mHealth apps for managing chronic diseases was heterogeneous, with roughly half of them falling short of acceptable standards for both quality and content. The majority of apps contained scant information about scientific evidence and the developer's history. To increase user confidence and accomplish desired health outcomes, mHealth apps should be optimized with the help of health care professionals. Future studies on mHealth content analysis should focus on other diseases as well.
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Affiliation(s)
- Khang Jin Cheah
- Center for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Zahara Abdul Manaf
- Center for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Arimi Fitri Mat Ludin
- Center for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nurul Huda Razalli
- Center for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | - Sawal Hamid Md Ali
- Electronic and Systems Engineering, Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, Selangor, Malaysia
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Knowles H, Swoboda TK, Sandlin D, Huggins C, Takami T, Johnson G, Wang H. The association between electronic health information usage and patient-centered communication: a cross sectional analysis from the Health Information National Trends Survey (HINTS). BMC Health Serv Res 2023; 23:1398. [PMID: 38087311 PMCID: PMC10717115 DOI: 10.1186/s12913-023-10426-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 12/04/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Patient-provider communication can be assessed by the patient-centered communication (PCC) score. With rapid development of electronic health (eHealth) information usage, we are uncertain of their role in PCC. Our study aims to determine the association between PCC and eHealth usage with the analysis of national representative survey data. METHODS This is a cross sectional analysis using the Health Information National Trends Survey 5 (HINTS 5) cycle 1 to cycle 4 data (2017-2020). Seven specific questions were used for PCC assessment, and eHealth usage was divided into two types (private-eHealth and public-eHealth usage). A multivariate logistic regression was performed to determine the association between PCC and eHealth usage after the adjustment of other social, demographic, and clinical variables. RESULTS Our study analyzed a total of 13,055 unweighted participants representing a weighted population of 791,877,728. Approximately 43% of individuals used private eHealth and 19% used public eHealth. The adjusted odds ratio (AOR) of private-eHealth usage associated with positive PCC was 1.17 (95% CI 1.02-1.35, p = 0.027). The AOR of public-eHealth usage associated with positive PCC was 0.84 (95% CI 0.71-0.99, p = 0.043). CONCLUSION Our study found that eHealth usage association with PCC varies. Private-eHealth usage was positively associated with PCC, whereas public-eHealth usage was negatively associated with PCC.
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Affiliation(s)
- Heidi Knowles
- Department of Emergency Medicine, JPS Health Network, 1500 S. Main St, Fort Worth, TX, 76104, USA
| | - Thomas K Swoboda
- Department of Emergency Medicine, The Valley Health System, Touro University Nevada School of Osteopathic Medicine, 657 N. Town Center Drive, Las Vegas, NV, 89144, USA
| | - Devin Sandlin
- Department of Emergency Medicine, JPS Health Network, 1500 S. Main St, Fort Worth, TX, 76104, USA
| | - Charles Huggins
- Department of Emergency Medicine, JPS Health Network, 1500 S. Main St, Fort Worth, TX, 76104, USA
| | - Trevor Takami
- Department of Emergency Medicine, JPS Health Network, 1500 S. Main St, Fort Worth, TX, 76104, USA
| | - Garrett Johnson
- Department of Emergency Medicine, JPS Health Network, 1500 S. Main St, Fort Worth, TX, 76104, USA
| | - Hao Wang
- Department of Emergency Medicine, JPS Health Network, 1500 S. Main St, Fort Worth, TX, 76104, USA.
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Chen Y, Kruahong S, Elias S, Turkson-Ocran RA, Commodore-Mensah Y, Koirala B, Himmelfarb CRD. Racial Disparities in Shared Decision-Making and the Use of mHealth Technology Among Adults With Hypertension in the 2017-2020 Health Information National Trends Survey: Cross-Sectional Study in the United States. J Med Internet Res 2023; 25:e47566. [PMID: 37703088 PMCID: PMC10534288 DOI: 10.2196/47566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 07/12/2023] [Accepted: 07/14/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND Mobile health (mHealth) technology has the potential to support shared decision-making (SDM) and improve hypertension control. However, our understanding of the variations in individuals' involvement in SDM and mHealth usage across different racial and ethnic groups in the United States is still limited. OBJECTIVE This study aimed to investigate the extent of involvement in SDM and the usage of mHealth technology in health-related activities among US adults with hypertension from diverse racial and ethnic backgrounds and to examine whether the mHealth usage differed by individuals' level of engagement in SDM. METHODS This study used cross-sectional data from the 2017 to 2020 Health Information National Trends Survey, which was conducted on US adults with self-reported hypertension, and race and ethnicity data were included. The exposure of interest was race and ethnicity. The outcomes were SDM and mHealth usage. SDM was assessed using an item: "In the past 12 months, how often did your health professional: involve you in decisions about your healthcare as much as you wanted?" mHealth usage was defined as using a smartphone or tablet to engage in (1) making health decisions, (2) discussing health decisions with health providers, (3) tracking health progress, and (4) sharing health information. Weighted multivariable logistic regression models were used to examine the association between race and ethnicity and SDM or mHealth usage adjusted for covariates and stratified by the level of engagement in SDM. RESULTS This study included 4893 adults with hypertension, and the mean age was 61 (SD 13) years. The sample was 53% female, 61% (n=3006) non-Hispanic White, 19% (n=907) non-Hispanic Black or African American, 12% (n=605) Hispanic, 4% (n=193) non-Hispanic Asian, and 4% (n=182) non-Hispanic other. Compared to the non-Hispanic White adults, non-Hispanic Black adults were more likely to use mHealth to make health decisions (adjusted odds ratio [aOR] 1.70, 95% CI 1.23-2.34), share health information (aOR 1.46, 95% CI 1.02-2.08), and discuss health decisions with health providers (aOR 1.38, 95% CI 1.02-1.87). Significant associations were observed specifically among those who were always involved in SDM. Asian adults were less likely to be involved in SDM (aOR 0.51, 95% CI 0.26-0.99) and were more likely to use mHealth to track progress on a health-related goal (aOR 2.07, 95% CI 1.28-3.34) than non-Hispanic White adults. Hispanic adults were less likely to use mHealth to share health information (aOR 0.47, 95% CI 0.33-0.67) and discuss health decisions with health providers (aOR 0.65, 95% CI 0.46-0.94) compared to non-Hispanic White adults. CONCLUSIONS This study observed racial and ethnic disparities in SDM and mHealth usage among US adults with hypertension. These findings emphasize the significance of comprehending the involvement of SDM and the usage of mHealth technology within racially and ethnically diverse populations.
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Affiliation(s)
- Yuling Chen
- Johns Hopkins School of Nursing, Baltimore, MD, United States
| | - Suratsawadee Kruahong
- Johns Hopkins School of Nursing, Baltimore, MD, United States
- Mahidol University Faculty of Nursing, Bangkok, Thailand
| | - Sabrina Elias
- Johns Hopkins School of Nursing, Baltimore, MD, United States
| | | | - Yvonne Commodore-Mensah
- Johns Hopkins School of Nursing, Baltimore, MD, United States
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Binu Koirala
- Johns Hopkins School of Nursing, Baltimore, MD, United States
| | - Cheryl R Dennison Himmelfarb
- Johns Hopkins School of Nursing, Baltimore, MD, United States
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
- Johns Hopkins School of Medicine, Baltimore, MD, United States
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Quach S, Michaelchuk W, Benoit A, Oliveira A, Packham TL, Goldstein R, Brooks D. Mobile heath applications for self-management in chronic lung disease: a systematic review. NETWORK MODELING AND ANALYSIS IN HEALTH INFORMATICS AND BIOINFORMATICS 2023; 12:25. [PMID: 37305790 PMCID: PMC10242585 DOI: 10.1007/s13721-023-00419-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 04/05/2023] [Accepted: 05/07/2023] [Indexed: 06/13/2023]
Abstract
Integration of mobile health (mHealth) applications (apps) into chronic lung disease management is becoming increasingly popular. MHealth apps may support adoption of self-management behaviors to assist people in symptoms control and quality of life enhancement. However, mHealth apps' designs, features, and content are inconsistently reported, making it difficult to determine which were the effective components. Therefore, this review aims to summarize the characteristics and features of published mHealth apps for chronic lung diseases. A structured search strategy across five databases (CINAHL, Medline, Embase, Scopus and Cochrane) was performed. Randomized controlled trials investigating interactive mHealth apps in adults with chronic lung disease were included. Screening and full-text reviews were completed by three reviewers using Research Screener and Covidence. Data extraction followed the mHealth Index and Navigation Database (MIND) Evaluation Framework (https://mindapps.org/), a tool designed to help clinicians determine the best mHealth apps to address patients' needs. Over 90,000 articles were screened, with 16 papers included. Fifteen distinct apps were identified, 8 for chronic obstructive pulmonary disease (53%) and 7 for asthma (46%) self-management. Different resources informed app design approaches, accompanied with varying qualities and features across studies. Common reported features included symptom tracking, medication reminders, education, and clinical support. There was insufficient information to answer MIND questions regarding security and privacy, and only five apps had additional publications to support their clinical foundation. Current studies reported designs and features of self-management apps differently. These app design variations create challenges in determining their effectiveness and suitability for chronic lung disease self-management. Registration: PROSPERO (CRD42021260205). Supplementary Information The online version contains supplementary material available at 10.1007/s13721-023-00419-0.
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Affiliation(s)
- Shirley Quach
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, ON Canada
- Respiratory Research, West Park Healthcare Center, Toronto, ON Canada
| | - Wade Michaelchuk
- Respiratory Research, West Park Healthcare Center, Toronto, ON Canada
- Rehabilitation Science Institute, Faculty of Medicine, University of Toronto, Toronto, ON Canada
| | - Adam Benoit
- Respiratory Research, West Park Healthcare Center, Toronto, ON Canada
| | - Ana Oliveira
- Respiratory Research, West Park Healthcare Center, Toronto, ON Canada
- Lab3R–Respiratory Research and Rehabilitation Laboratory, University of Aveiro (ESSUA), Aveiro, Portugal
| | - Tara L. Packham
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, ON Canada
| | - Roger Goldstein
- Respiratory Research, West Park Healthcare Center, Toronto, ON Canada
- Rehabilitation Science Institute, Faculty of Medicine, University of Toronto, Toronto, ON Canada
| | - Dina Brooks
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, ON Canada
- Respiratory Research, West Park Healthcare Center, Toronto, ON Canada
- Rehabilitation Science Institute, Faculty of Medicine, University of Toronto, Toronto, ON Canada
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Wang H, Shen C, Barbaro M, Ho AF, Pathak M, Dunn C, Sambamoorthi U. A Multi-Level Analysis of Individual and Neighborhood Factors Associated with Patient Portal Use among Adult Emergency Department Patients with Multimorbidity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1231. [PMID: 36673986 PMCID: PMC9859180 DOI: 10.3390/ijerph20021231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 01/03/2023] [Accepted: 01/06/2023] [Indexed: 06/17/2023]
Abstract
Background: Patient portals tethered to electronic health records (EHR) have become vital to patient engagement and better disease management, specifically among adults with multimorbidity. We determined individual and neighborhood factors associated with patient portal use (MyChart) among adult patients with multimorbidity seen in an Emergency Department (ED). Methods: This study adopted a cross-sectional study design and used a linked database of EHR from a single ED site to patients’ neighborhood characteristics (i.e., zip code level) from the American Community Survey. The study population included all adults (age > 18 years), with at least one visit to an ED and multimorbidity between 1 January 2019 to 31 December 2020 (N = 40,544). Patient and neighborhood characteristics were compared among patients with and without MyChart use. Random-intercept multi-level logistic regressions were used to analyze the associations of patient and neighborhood factors with MyChart use. Results: Only 19% (N = 7757) of adults with multimorbidity used the patient portal. In the fully adjusted multi-level model, at the patient level, having a primary care physician (AOR = 5.55, 95% CI 5.07−6.07, p < 0.001) and health insurance coverage (AOR = 2.41, 95% CI 2.23−2.61, p < 0.001) were associated with MyChart use. At the neighborhood level, 4.73% of the variation in MyChart use was due to differences in neighborhood factors. However, significant heterogeneity existed in patient portal use when neighborhood characteristics were included in the model. Conclusions: Among ED patients with multimorbidity, one in five adults used patient portals. Patient-level factors, such as having primary care physicians and insurance, may promote patient portal use.
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Affiliation(s)
- Hao Wang
- Department of Emergency Medicine, JPS Health Network, Integrative Emergency Services, 1500 S. Main St., Fort Worth, TX 76104, USA
| | - Chan Shen
- Department of Surgery, Penn State Cancer Institute, Hershey, PA 17033, USA
| | - Michael Barbaro
- Department of Emergency Medicine, JPS Health Network, Integrative Emergency Services, 1500 S. Main St., Fort Worth, TX 76104, USA
| | - Amy F. Ho
- Department of Emergency Medicine, JPS Health Network, Integrative Emergency Services, 1500 S. Main St., Fort Worth, TX 76104, USA
| | - Mona Pathak
- Department of Pharmacotherapy, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
| | - Cita Dunn
- TCU and UNTHSC School of Medicine, 3500 Camp Bowie Blvd, Fort Worth, TX 76107, USA
| | - Usha Sambamoorthi
- Texas Center for Health Disparities, Department of Pharmacotherapy, College of Pharmacy, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
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Fedkov D, Berghofen A, Weiss C, Peine C, Lang F, Knitza J, Kuhn S, Krämer BK, Leipe J. Efficacy and safety of a mobile app intervention in patients with inflammatory arthritis: a prospective pilot study. Rheumatol Int 2022; 42:2177-2190. [PMID: 36112186 PMCID: PMC9483251 DOI: 10.1007/s00296-022-05175-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 07/20/2022] [Indexed: 11/30/2022]
Abstract
AbstractEULAR highlighted the essential role of digital health in increasing self-management and improving clinical outcomes in patients with arthritis. The objective of this study was to evaluate the efficacy and safety of the digital health application (DHA) in patients with inflammatory arthritis. We assessed demographic parameters, treatment regimen, disease activity, and other patient-reported outcomes at baseline and after 4 weeks of DHA use added to standard care treatment. Of 17 patients, who completed the study, 7 (41.2%) patients were male, ranging from 19 to 63 (40.5 ± 12.2) years. No significant change in antirheumatic treatment was observed during the study. Statistically significant improvements (p < 0.05) were noted for health-related quality of life (increase in Physical Component Summary of Short Form-36 (SF-36) by 23.6%) and disease activity (decrease of Clinical Disease Activity Index and Simple Disease Activity Index by 38.4% and 39.9%, respectively). Clinically significant improvement was demonstrated for SF-36 Total Score (+ 14.4%), disease activity (Rheumatoid Arthritis Disease Activity Index− 5 to 15.9%), and depression (Patient Health Questionnaire− 9 to 13.5%). None of the efficacy parameters showed negative trends. No adverse events were reported throughout the study. The usability level was high i.e., the mean mHealth Application Usability Questionnaire Score of 5.96 (max.: 7.0) demonstrated a high level of application usability. This suggests that using a personalized disease management program based on DHA significantly improves several measures of patient-reported outcomes and disease activity in patients with inflammatory arthritis in a timely manner. These findings highlight the potential of complementary digital therapy in patients with inflammatory arthritis.
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Affiliation(s)
- Dmytro Fedkov
- Department of Internal Medicine #3, Bogomolets National Medical University, Kiev, Ukraine
| | - Andrea Berghofen
- Medical Clinic, Medical Faculty Mannheim of the University Heidelberg, Mannheim, Germany
| | - Christel Weiss
- Department of Medical Statistics and Biomathematics, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer, Mannheim, Germany
| | | | | | - Johannes Knitza
- Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Ulmenweg, Erlangen, Germany
- Deutsches Zentrum Für Immuntherapie (DZI), Friedrich-Alexander-University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Université Grenoble Alpes, AGEIS, Grenoble, France
| | - Sebastian Kuhn
- Department of Digital Medicine, Bielefeld University—Medical Faculty OWL, Bielefeld, Germany
- Department of Orthopaedic and Trauma Surgery, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Bernhard K. Krämer
- Department of Medicine (Nephrology, Rheumatology, Pneumology), University Hospital Mannheim, University of Heidelberg, HypertensiologyMannheim, Endocrinology Germany
| | - Jan Leipe
- Medical Clinic, Medical Faculty Mannheim of the University Heidelberg, Mannheim, Germany
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