JMIR Publications

ABSTRACT

Background:

Lifestyle modification in patients with non-alcoholic fatty liver disease (NAFLD) is key to improving health outcomes. Mobile health technologies may offer potential effective and efficient healthcare support to facilitate self-management.

Objective:

This study aims to develop a lifestyle coaching intervention using a mobile app for patients with NAFLD and evaluate physiological and psychological health outcomes for six months.

Methods:

This study was a randomized controlled trial. The personalized lifestyle coaching intervention using a mobile app was developed through established guidelines and literature reviews. This intervention consisted of information on NAFLD management, diet and physical activity self-monitoring, and coaching sessions based on patient records and text messages. A total of 102 individuals were enrolled in the study and randomly assigned to the intervention group (N=48) or control group (N=54). The outcomes were improvements in physiological (weight, liver fat score, AST, ALT, and gamma-GT) and clinical outcomes (self-management, NAFLD self-management knowledge, self-efficacy, fatigue, depression, and quality of life). Data were analyzed using descriptive analysis and a linear mixed model to test the effects of the intervention.

Results:

All participants completed the study. The mean age of the participants was 48.9 (standard deviation 13.74) years. 38.2% (39/102) were females, and 65.7% (67/102) were married. There were no differences in baseline demographic and clinical data between the intervention and control groups. Changes from baseline to six months in the intervention group were only significant for weight (P<.001), liver fat score (P =.011), AST (P=.034), ALT (P=.002), gamma-GT (P=.036), self-management (P<.001), fatigue (P=.005), depression (P=.003), and quality of life (P<.001). The differences between the two groups over the six months were significant in self-management (P=.004), self-management knowledge (P=.037), fatigue (P=.004), depression (P=.036), and quality of life (P=.013). Linear mixed models showed that the intervention was significantly effective only for self-management (P=.006) and fatigue (P=.020), with no significant effects observed in other variables.

Conclusions:

Non-pharmacological interventions using a mobile app may be effective in improving the physiological and psychological health outcomes of patients with NAFLD. Clinical Trial: Clinical Research Information Service registry KCT0005549 was registered on October 29, 2020.