Article
Frequent use of app diary functions in a digital health project with rheumatoid arthritis patients
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Authors
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Christina Nannen
- Hiller Forschungszentrum für Rheumatologie, Heinrich-Heine-Universität Düsseldorf, Düsseldorf
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Gamal Chehab
- Poliklinik, Funktionsbereich & Hiller Forschungszentrum für Rheumatologie, UKD, Heinrich-Heine-Universität Düsseldorf, Düsseldorf
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Hasan Acar
- Poliklinik, Funktionsbereich & Hiller Forschungszentrum für Rheumatologie, UKD, Heinrich-Heine-Universität Düsseldorf, Düsseldorf
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Arnd Becker
- Ortenau Klinikum Offenburg-Gengenbach, Med. Klinik Gengenbach, Gengenbach
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Matthias Schneider
- Poliklinik, Funktionsbereich & Hiller Forschungszentrum für Rheumatologie, UKD, Heinrich-Heine-Universität Düsseldorf, Düsseldorf
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Jutta Richter
- Poliklinik, Funktionsbereich & Hiller Forschungszentrum für Rheumatologie, UKD, Heinrich-Heine-Universität Düsseldorf, Düsseldorf
| Published: | February 5, 2019 |
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Outline
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Background: Within the MiDEAR (Mobile medically supervised patient management in rheumatoid arthritis patients using DocuMed.rh and RheumaLive App) project rheumatoid arthritis (RA) patients (pts) used and evaluated a mobile medical Application (App) with diary functions over nine months. It includes the Hannover Functional Questionnaire (FFbH) and a modified RA disease activity index questionnaire (RADAI). Additionally, pts may document morning stiffness (MST), pain (visual analogue scale), incapacity to work and medication. We studied pts’ everyday use of this App, amongst others which functions were used.
Methods: Inclusion criteria were RA diagnosis and age ≥18 years. 268 consecutive RA out-pts (73.5% female) were screened, 157 (58.6%, 77.7% female) owned an App-capable Smartphone/Tablet. At baseline 60 out-pts consented to MiDEAR. Pts downloaded the App on their own device, documented data voluntarily on not pre-specified intervals. On their routine out-pts visits pts evaluated the Apps’ use, usability and feasibility on paper-based questionnaires at three time-points. Reported percentages depict valid answers. Ethical approval and signed informed consents were obtained. Clinicaltrials.gov identifier is NCT02565225.
Results: Pts were predominantly female (78.3%), mean±SD age was 50.1±13.1 years, mean disease duration 10.5±9.1 years. 43 pts (71.7%) remained in the project until the first, 41 (68.3%) until the second and 38 pts (63.3%) until the third follow-up. Reasons to terminate MiDEAR early were mostly not App-related reasons.
Pts used most diary functions (T3=97.7% (n=42); T6=79,4% (n=27); T9=75.7% (n=28)), and documented disease-related parameters, see Table 1 [Tab. 1].
The App is preferred to the paper-versions to fill-in FFbH and RADAI (T3=85.7% (n=30); T6=87.9% (n=29); T9=79.4% (n=27)). In the App the completion of both the RADAI and FFbH was favored by 66.7-73.1% at all study points. The single use of one of the instruments was demanded less fre-quently (0-33.3%).
FFbH and RADAI were judged as meaningful (likert scale 1 (very meaningful) - 6 (very unmeaningful)) at all follow-up visits, (FFbH: 2.7±1.3 (T3); 2.4±1.4 (T6); 2.3±1.0 (T9) and RADAI: 2.2±1.1 (T3); 2.2±1.1 (T6); 2.0±0.7 (T9), (mean±SD)). During the complete study period the transfer of self-reported App-data into the clinic patient documentation system was appreciated by most pts (62.5-63.6%).
Conclusion: Pts used most of the diary functions and documented their disease-related parameters over nine months. Combined use of App-RADAI and -FFbH is preferred. Apps are valuable tools for pts to document disease-related parameters. Thus physicians may gain improved insights on the course of the disease between out-pts visits. Further investigations in larger cohorts and over longer periods of time to assess App-adherence are warranted.
Financial grant: UCB Pharma GmbH
