Implementation of a Web-Based Application (Wellhealth) for Osteoporosis Medication Management in Older Adults:...

Osteoporosis is a major global health challenge, but treatment uptake and long-term adherence remain low, raising the risk of future fractures. Barriers to effective care include low patient awareness, financial constraints, and challenges with ongoing monitoring and follow-up. Although mobile health and telemedicine tools can support chronic disease management, many osteoporosis apps lack clinical validation and structured medication management features.

This study aimed to evaluate the feasibility of implementing a newly developed web-based application, Wellhealth, to support osteoporosis treatment management. A secondary objective was to explore potential associations between patient demographic characteristics and the frequency of in-app medication logging over a 1-year period.

We conducted a feasibility study at the Golden Jubilee Medical Center, Mahidol University, between January 2023 and March 2025. Participants were recruited using convenience sampling during routine outpatient osteoporosis clinic visits. Eligible patients with a primary osteoporosis diagnosis used the Wellhealth web-based system, including the Assisted Liaison Service feature, over a 1-year period. Weekly in-app reports of medication use, satisfaction, and related outcomes were analyzed. Feasibility outcomes were summarized using descriptive statistics. Potential associations between participant characteristics and consistent in-app medication logging were explored using univariable and multivariable logistic regression analyses. Differences between in-app medication logging rates and medication possession ratio values were summarized using medians and IQRs.

We enrolled 32 participants with a mean age of 71 (range 58-91) years. The average in-app medication logging rate was 62.38% (SD 27.4%) for antiosteoporosis medications and 64.67% (SD 34.5%) for calcium supplementation. Vitamin D logging data were available for 27 participants, with an average logging rate of 68.23% (SD 31.6%). Overall satisfaction with the application was high, with 49% (15/32) of participants reporting high satisfaction, 42% (14/32) good, and 9% (3/32) average. User interaction increased markedly between the first and third quarters of 2023 before stabilizing through the second quarter of 2024. In multivariable analysis, consistent calcium logging was the only factor independently associated with higher antiosteoporosis logging rates (P=.02). Although younger age was associated with higher logging in univariable analysis (P=.01), this was no longer significant after multivariable adjustment (P=.12).

Use of the Wellhealth system was feasible in this small cohort, with consistent medication logging, high user acceptability, and sustained digital engagement. Only consistent calcium logging was independently associated with higher antiosteoporosis medication tracking rates. Larger studies are needed to assess the app's clinical effectiveness and impact on long-term outcomes.