Rheumatology and therapy · 2026
Characterizing Adherence to a Mobile Health App for Patient-Reported Outcomes in Rheumatoid Arthritis.
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Tuzun Zeynep Serra, Santacroce Leah, Ørbo Hilde S, Fukui Sho, Tedeschi Sara K, Solomon Daniel H
Аннотация
INTRODUCTION: Adoption of mobile health applications ("apps") that collect patient-reported outcomes (PROs) into clinical practice remains limited, and studies about patient usage preferences are lacking. Our aim was to characterize adherence to a PRO app designed for patients with rheumatoid arthritis (RA).
METHODS: We performed a post hoc analysis of a non-randomized trial of a PRO app for patients with RA seen at an academic medical center. The 12-month trial enrolled 149 participants with RA. The app collected one of four PROs every other day. We calculated adherence using two methods: (1) percent of PROs completed, and (2) time until app non-use. These calculations used different intervals for PRO completion and different periods of non-use to define adherence. We also investigated the association of potential predictors on the outcome using multivariable regression models.
RESULTS: The percentage of completed PROs was 43.5% (standard deviation, SD = 27.8) using a 2-day interval between PROs; this included all possible PRO questionnaires. Adherence was 68.0% (SD = 34.0) for any completion in an 8-day interval, and 77.3% (SD = 30.9) for a 32-day interval. In survival analyses, describing time until app non-use, the mean number of days until cessation was 153.8 days (SD = 94.1), defining non-use as ≥ 32 days without PRO completion and 152.3 days (SD = 95.8) for ≥ 64 days. We observed that older age and more frequent physician engagement with the PROs data were associated with greater adherence and increased time until cessation.
CONCLUSIONS: Adherence to longitudinal PRO symptom reporting through an app was moderate and varied depending on how it was measured; the 8-day interval (approximately 1 week) is likely the most realistic expectation for patient completion of PRO symptoms. Adherence correlates with patient and physician factors.
METHODS: We performed a post hoc analysis of a non-randomized trial of a PRO app for patients with RA seen at an academic medical center. The 12-month trial enrolled 149 participants with RA. The app collected one of four PROs every other day. We calculated adherence using two methods: (1) percent of PROs completed, and (2) time until app non-use. These calculations used different intervals for PRO completion and different periods of non-use to define adherence. We also investigated the association of potential predictors on the outcome using multivariable regression models.
RESULTS: The percentage of completed PROs was 43.5% (standard deviation, SD = 27.8) using a 2-day interval between PROs; this included all possible PRO questionnaires. Adherence was 68.0% (SD = 34.0) for any completion in an 8-day interval, and 77.3% (SD = 30.9) for a 32-day interval. In survival analyses, describing time until app non-use, the mean number of days until cessation was 153.8 days (SD = 94.1), defining non-use as ≥ 32 days without PRO completion and 152.3 days (SD = 95.8) for ≥ 64 days. We observed that older age and more frequent physician engagement with the PROs data were associated with greater adherence and increased time until cessation.
CONCLUSIONS: Adherence to longitudinal PRO symptom reporting through an app was moderate and varied depending on how it was measured; the 8-day interval (approximately 1 week) is likely the most realistic expectation for patient completion of PRO symptoms. Adherence correlates with patient and physician factors.