Characterizing Adherence to a Mobile Health App for Patient-Reported Outcomes in Rheumatoid Arthritis

Area of Science:

• Digital Health
• Rheumatology
• Patient-Reported Outcomes

Background:

• Limited adoption of mobile health applications (apps) for collecting patient-reported outcomes (PROs) in clinical practice.
• Lack of studies investigating patient usage preferences for PRO apps in rheumatoid arthritis (RA).
• Need to characterize adherence to PRO apps for RA management.

Purpose of the Study:

• To characterize patient adherence to a PRO app designed for individuals with rheumatoid arthritis (RA).
• To identify predictors associated with adherence and sustained app usage.

Main Methods:

• Post hoc analysis of a 12-month non-randomized trial involving 149 RA patients using a PRO app.
• App collected one of four PROs every other day.
• Adherence calculated by percent of PROs completed and time until app non-use, using various intervals and non-use definitions.
• Multivariable regression models investigated predictors of adherence.

Main Results:

• PRO completion rates varied: 43.5% (2-day interval), 68.0% (8-day interval), and 77.3% (32-day interval).
• Mean time until app cessation was approximately 153 days, defined by 32 or 64 days of non-use.
• Older patient age and increased physician engagement with PRO data correlated with higher adherence and longer app usage.

Conclusions:

• Adherence to longitudinal PRO symptom reporting via app is moderate and measurement-dependent.
• An 8-day interval (weekly) represents a realistic expectation for patient PRO completion.
• Patient and physician factors significantly influence adherence to PRO apps in RA.