JMIR Publications

ABSTRACT

Background:

While mobile health applications (mHealth apps) have been made for various diseases, including sickle cell disease (SCD), most focus on a single purpose. SCD is a chronic disease that requires knowledge of the disease, self-management, and adherence to treatment plans. While mHealth apps have been made with single features for SCD, there is limited understanding of using a mHealth app with a more comprehensive set of features that could engage adults with SCD depending on what features they prefer and need to engage and empower them in their disease.

Objective:

We evaluated the usage of a mHealth app with various features, including pain tracking, quizzes for patient-facing guidelines, pain and asthma action plans, and goal setting.

Methods:

Adults with SCD were enrolled at two sickle cell centers between 2018-2022 as part of a 6-month feasibility randomized controlled trial with participants completing surveys at baseline and 6 months. Participants were randomized into receiving either a mHealth app + booklet with patient-facing guidelines or a booklet with the guidelines alone. The mHealth app comprised web pages with patient-facing guideline material and a Research Electronic Data Capture (REDCap) project. The REDCap project included a personal profile, a pain tracker, goal setting, quizzes about the guidelines, and pain or asthma action plans. The REDCap project also included the ability to send daily text messages at a time they chose, which contained a message they could create and a link to their profile. Outcomes included SCD-specific knowledge and acute healthcare utilization (emergency room visits and hospitalizations). We evaluated the usage of these different features and relationships with baseline variables, each other, and study outcomes.

Results:

Approximately 75% (50 of 67) of the enrolled and randomized participants completed all the study components, and 100% (26 of 26) of the participants who were randomized to the mHealth app arm and completed the study used the mHealth app. Further, 15 (50%) participants used multiple features. Baseline sickle cell knowledge and female gender were associated with more usage of pain diary (p=0.04) and mission (p=0.046) features, respectively. While not significant, mission completion was associated with lower hospitalizations (p=0.063).

Conclusions:

Adults with SCD engaged differently with a mHealth app with multiple features. As this study was not focused on one part of our app, engagement with features in this app was entirely patient-driven, which may demonstrate the expected real-world use of a mHealth app in this population. A multipurpose app can help engage participants in self-management strategies through different features and potentially improve outcomes. Clinical Trial: This clinical trial is registered on https://clinicaltrials.gov/ with study ID: NCT03629678.