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Published on: April 19, 2019
One-Year Experiences with a Personalized eHealth App to Guide Patients with an Abdominal Aortic Aneurysm and Their
Bergin Gjosha1, Rebecca van Gorkom2, Fleur Toonders2
1Department of Vascular Surgery, Amphia Hospital, Breda, The Netherlands; TIAS School for Business and Society, Tilburg, The Netherlands.
Background:
Electronic health (eHealth) interventions may reduce the clinical demand of abdominal aortic aneurysm (AAA) care. However, how older AAA-patients use apps during long-term follow up remains under-explored. This study evaluated a personalized perioperative smartphone application (app) for AAA-patients and caregivers.
Methods:
Long-term app use was prospectively assessed in patients undergoing AAA repair and their informal caregivers. The app provided personalized perioperative information (lifestyle advice on physical exercise, nutrition, and reducing smoking and alcohol intake), and automatically collected user engagement metrics, patient-reported outcome measures (PROMs), caregiver outcome measures (COMs), patient-satisfaction questionnaires, and lifestyle behavior questionnaires. Use was assessed by app retention, user engagement, and questionnaire response rates.
Results:
App-retention was 90% at 12 months in 118 patients (mean age 74 years) and 82 caregivers. User-engagement was significantly higher up to 2 months postoperatively than thereafter (P < 0.001). App-based PROMs response rates were lower only at 12 months than a paper-based control cohort of 152 AAA-patients and 99 caregivers (59% versus 94%, P = 0.018), while COMs response rates did not differ significantly. Median patient satisfaction was ≥7 at all time points for guidance, information, usefulness, and recommendation, except usefulness at 6 and 12 months. Among smokers and alcohol users (≥7 units/week), 50% smoked less and 38% drank less at 12 months.
Conclusion:
The personalized eHealth app demonstrated high long-term retention and user engagement in older AAA patients, was positively valued, and may positively influence lifestyle behavior. Administering app-based PROMs and COMs was feasible, but yielded lower response rates at 12 months. Supplementing app-based PROMs with paper-based PROMs may improve response rates.
