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Development of a mobile health application to support the management of paediatric FMF
Yunus Emre Bayrak1, Hikmetcan Özcan2, Fatih Pir2
1Faculty of Medicine, Department of Pediatric Rheumatology, Kocaeli University, Kocaeli, Turkey.
Objective:
FMF is highly prevalent in Mediterranean countries and represents a substantial proportion of paediatric rheumatology patients. Colchicine, the mainstay of treatment, requires lifelong daily use, yet long-term adherence remains challenging, leading to recurrent attacks and increased healthcare burden. This study aimed to develop a freely downloadable mobile application to improve medication adherence by providing reminders and enabling direct communication with physicians.
Methods:
The application was designed as a structured medication-timing and monitoring tool, providing time-specific medication reminders, real-time intake confirmation ('taken/missed') and digital adherence tracking. The user interface was tailored to the needs of patients and parents, considering children's attention span, parental workload and health literacy. Following pilot testing in seven volunteer patients, the application was refined based on user feedback. Physicians used a web-based panel to register patients, define prescriptions and treatment schedules, and assign calendar-based appointments. Medication adherence was assessed using the MASIF scale, and disease activity was evaluated using the AIDAI score. A total of 93 patients with FMF were included in the study.
Results:
Before application use, adherence was low, with a median MASIF score of 44 and most patients demonstrating poor adherence. After implementation, MASIF scores significantly improved at 3, 6 and 12 months, with a marked reduction in poorly adherent patients (P < 0.001). AIDAI scores and attack frequency significantly decreased, and no patient had an AIDAI score >9 during follow-up. Agreement between application-measured adherence and MASIF scores was excellent (ICC > 0.90).
Conclusion:
Mobile reminder applications are low-cost, accessible digital health tools with strong potential to enhance medication adherence in FMF patients.
Insights
A new mobile app significantly improved medication adherence for Familial Mediterranean Fever (FMF) patients by providing reminders and physician communication. This digital health tool led to reduced disease activity and fewer attacks, demonstrating its effectiveness in managing chronic conditions.
Area of Science:
- Digital Health
- Pediatric Rheumatology
- Chronic Disease Management
Background:
- Familial Mediterranean Fever (FMF) is common in Mediterranean regions, posing a significant challenge in pediatric rheumatology.
- Lifelong colchicine treatment for FMF has poor adherence, leading to recurrent attacks and increased healthcare costs.
Purpose of the Study:
- To develop and evaluate a mobile application designed to improve medication adherence in FMF patients.
- The app aimed to provide medication reminders and facilitate physician communication to enhance treatment compliance.
Main Methods:
- A mobile application was developed with features for medication timing, reminders, and adherence tracking.
- User interface was optimized for patients and parents; pilot testing and refinement were conducted.
- 93 FMF patients were enrolled, with adherence assessed by MASIF scale and disease activity by AIDAI score.
Main Results:
- Pre-app adherence was low (median MASIF 44), significantly improving post-implementation at 3, 6, and 12 months (p < 0.001).
- Disease activity (AIDAI scores) and attack frequency decreased significantly.
- Excellent agreement (ICC >0.90) was found between app-measured adherence and MASIF scores.
Conclusions:
- Mobile reminder applications are effective, low-cost digital health tools for improving FMF medication adherence.
- These accessible tools show strong potential for enhancing patient management and reducing the burden of chronic inflammatory diseases.
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