Impact of an eHealth Smartphone App on the Mental Health of Patients With Psoriasis: Prospective Randomized Controlled Intervention Study (Preprint)

Abstract

BACKGROUND Psoriasis has a negative impact on patients’ mental and physical health. Disease management strategies including educational programs and eHealth devices can improve health care in chronic diseases. OBJECTIVE Combining an educational program with a disease management smartphone application has been shown to reduce depressive symptoms in psoriasis patients over 24 weeks. Here, we present results of the 60-week long-term study period. METHODS Psoriasis patients of the intervention group received an educational program, visits on week 0, 12, 24, 36, and 60, and access to the study-app. The control group attended the visits, only. Additionally, effects of the app usage frequency were assessed. Primary endpoints were a significant reduction of the Hospital Anxiety and Depression Score (HADS-A/-D). RESULTS 107 patients were included in the study and randomized into the control (n = 53) or intervention group (n = 54). 77 patients completed the study. A significant reduction in HADS D in the intervention group was found in week 12 (P = .04) and 24 (P = .005), but not in week 36 (P = .12) and 60 (P = .32). Patient stratification according to their app usage frequency showed a significant improvement of the HADS-D at week 36 (P = .004) and 60 (P = .04) and in the HADS-A at week 36 (P = .04) and 60 (P = .05) in the group using the app less than once a month. CONCLUSIONS These findings support the usage of a disease management smartphone application as a valid tool to achieve a long-term improvement of psoriasis patients’ mental health, if not used too frequently. CLINICALTRIAL Drks.de DRKS00020755 (https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00020755)