Thu0699-Hpr is a Smartphone Application Useful for Self-Management Support in Patients With a Rheumatic Disease? 

Abstract

BackgroundFor patients with a rheumatic disease (RD), self-management is the effort to find a balance between the demands of the disease and the activities of daily life. Self-management is an important aspect in the care for patients with a RD, in which they are expected to take an active role. Over the past decade, new technologies have been developed to support self-management, including smartphone apps. These apps perfectly fit the idea that patients prefer an active role in self-management. Therefore, a smartphone application (app) was developed.ObjectivesThis study 1) investigates whether the use of an app improved patients’ self-management, 2) explores patients’ experiences with this RD-app, 3) investigates which factors are associated with the use of the RD-app.MethodsWe performed a prospective before-after study among patients with a RD. The primary outcome was patients’ self-management behavior measured with the Partners in Health scale (PIH), a generic validated 12 item self-rated scale, which indicates higher scores for better self-management behavior (1). A paired t-test was used to evaluate changes in the PIH-scale score after three months. To measure the user-experience with the app, survey questions addressed whether the RD-app had contributed to get more grip (or not) on the disease and how (why not). Logistic regression analyses served to investigate variables that are important for using the RD-app.ResultsOf the 1511 eligible patients, 397 completed both the baseline and the follow-up surveys. Participants who completed both questionnaires were most frequently diagnosed with RA, 65% was female and the mean age was 52.0 (SD 15.6) years. Hundred-fourteen participants used the RD-app. Self-management behavior did not improve according to the PIH score in the app-users group after 3 months. However, 42% of the app-users perceived that use of the RD-App had contributed to get more grip on the disease. Receiving tips, information on exercises and gaining insight on self-reported disease activity contributed to get more grip on the disease. However, the other app-users whom did not get more grip on the disease indicated the following reasons: information was not useful, no need for information or additional help, technical issues and too little usage of the app itself. Almost all users would recommend the app to others. To investigate who did use the RD-app, univariate analysis revealed a role for female patients, positive expectations of the RD-app, help needed to get more grip on the disease and a higher VAS global as associated factors with actually using the RD-app. In the multivariate analysis only positive expectations of the RD-app remained significantly associated with actually using the RD-app (p=<0.001).ConclusionAlmost one third used the RD-app. Although the PIH-score did not change, 42 percent of the participants thought the app helped them to get more grip on the disease. Therefore, the RD-app may be useful for additional self-management support in a clinical practice. Participants seemed ...