Solving the Hydroxychloroquine Dosing Dilemma With a Smartphone App

Abstract

Hydroxychloroquine retinopathy (HCR) is a potentially blinding disease. Once HCR is detected, there is no treatment and the disease often continues to progress, even when the medication is stopped. Hence, primary prevention by appropriate dosing of hydroxychloroquine offers the best chance of minimizing the risk of HCR. This strategy remains challenging in practice as up to 56% of patients receive hydroxychloroquine at doses that place them at higher risk for HCR. 1 A key reason is disagreement in how to calculate dosages of hydroxychloroquine. 2,3 There are 2 methods: one uses ideal body weight (IBW); the other uses actual body weight (ABW). The IBW method assumes that hydroxychloroquine is stored mostly in lean tissue. 2 The daily dose must be normalized by lean body mass. This makes the calculation more complicated than the ABW method, which assumes that the drug is distributed evenly in muscle, skin, and fat. 3 We describe a free smartphone app-DoseCheckerthat can rapidly calculate the optimal weekly dose of hydroxychloroquine using elements of both methods.

Social Networking App Use Among Primary Health Care Professionals: Web-Based Cross-Sectional Survey

“…The most popular social and messaging platforms used by health professionals were the same, and they had similar usage patterns in their professional context. The limited use of other more specialized groups of health apps in our study differed from the findings of other studies conducted in populations that used these apps constantly, especially those that are used for direct patient management (eg, medical guidelines and medical calculators) [29,34], which could be explained by poor knowledge of the current market or by technological barriers, especially among certain age segments of users. Although there are more specialized health apps that offer similar communication features and tend to have better safety profiles and certification in the handling of data [21], the lack of information and poor knowledge about them could be preventing their use.…”

“…The use of SNSs as a means of communicating with patients has been reported as being of little use, probably, according to other studies, due to the lack of legal protection, because their use could be a source of errors or distractions [32], or because of the preference for face-to-face contact with their physicians by a large part of the population [33]. This trend could change in the near future, as pointed out by some studies carried out in places where mobile phones are mostly used, since it can improve patient care and make the use of resources more efficient [29-31,34].…”

Somatotype, the risk of hydroxychloroquine retinopathy, and safe daily dosing guidelines

“…A line can be drawn for which the RBW and IBW methods yield the same threshold for safe dosing. 9 The line depends on the IBW algorithm chosen. Figure 5 shows the line corresponding to the algorithm used by Melles and Marmor 6 (a modified Devine algorithm in which IBW for all patients of height ≤60 in is arbitrarily set to 100 pounds).…”

“…A convenient smartphone application (DoseChecker) has been designed to provide safer dosing using this approach. 9 …”

“…The DoseChecker smartphone application is a simple way for the clinician to incorporate these principles into practice. 9 …”