Optimization of a mobile application for the management of hepatitis D based on patient experience: An observational...

Chronic hepatitis caused by the hepatitis D virus (HDV) represents one of the most aggressive forms of viral liver disease, associated with accelerated progression to cirrhosis and an increased risk of hepatocellular carcinoma. Its management is not yet well standardized, which justifies the exploration of digital tools to improve the care of these patients.

To evaluate the user experience, perceived usefulness, and usability of the NORA mobile application in patients with hepatitis D virus and/or HDV infection, as well as to analyze the determinants of non-use from a patient-centered perspective.

Cross-sectional observational study conducted in outpatient hepatology clinics. A total of 52 patients were included (19 users, 11 non-users, and 22 new users). Sociodemographic, clinical, and app usage variables were collected. Usability was assessed using the Mobile App Usability Questionnaire.

Users rated the application positively (Mobile App Usability Questionnaire 5.07±1.43), particularly highlighting the quality-of-life and education modules, while biometric modules were the least used. The main improvements proposed included expanded educational content (57.9%), improved data visualization (31.6%), and greater communication with the healthcare team (21.1%). Lack of motivation was the main barrier among non-users (72.7%). Expectations exceeded actual use in most modules, suggesting areas for improvement. Adoption was associated with detectable HDV RNA and recent follow-up.

NORA is a well accepted tool among users and is perceived as useful for the follow-up of patients with HDV. Optimizing aspects related to education, communication, and functionality could further enhance its impact in telemedicine. However, the methodological limitations of the study prevent any conclusions from being drawn regarding its clinical impact.