DataSheet_1_Design and implementation of a mobile app for the pharmacotherapeutic follow-up of patients diagnosed with immune-mediated inflammatory diseases: eMidCare.doc

BackgroundPharmacotherapeutic management of immune-mediated inflammatory diseases (IMID) has become more complex due to the development of new treatments, such as biological therapies. Mobile health, especially apps, can provide IMID patients with greater autonomy and facilitate communication with healthcare professionals. Our objective was to design and implement an app for remote monitoring and communication with IMID patients.
MethodsA multidisciplinary group was created to design and develop an app for IMID patients in a tertiary hospital. The app functionalities were identified through a focus group with IMID patients and through an observational, descriptive study of available apps for IMID patients at App Store and Play Store platforms. Once the app was designed and developed, we offered the app to IMID patients who initiated a new biological therapy. The inclusion period was from December 2020 to August 2021. We performed an observational, longitudinal study to assess the app’s impact on medication safety, communication, satisfaction, and usability.
ResultsWe designed an app (eMidCare®) with the following modules: My Medication, My Questionnaires, Adverse Events, Useful Information, Messages, and Patient Profile. A total of 85 patients were installed with the app. The median (range) follow-up time for app use was 123 (5-270) days. In the My Medication module, 100% of patients registered their biological therapy and 25.9% also used this module to record each dose of medication administered. A total of 82 adverse events (AEs) were registered. Thirty-two percent of the patients registered at least 1 AE. The most frequent AEs were fatigue, injection site reaction, headache, and nausea. Fifty-two percent of patients used the Messages module to communicate with healthcare professionals. The most frequent messages concerned doubts about managing AEs (26.2%) and drug interactions (18.9%). The satisfaction survey yielded a median (range) score of 9.1 (7-10) out of 10.
ConclusionsWe developed an app, eMidCare®, which reminds patients to take their medication, enables them to record AEs, and helps them communicate with healthcare professionals. Approximately one-third of the patients registered the administration of the biological therapies and registered at least 1 AE. The most used and most satisfactory functionality was communication with health professionals.

背景：随着生物疗法等新型治疗手段的发展，免疫介导性炎症疾病（immune-mediated inflammatory diseases, IMID）的药物治疗管理愈发复杂。移动健康（mobile health, mHealth）工具尤其是移动应用程序，可赋予IMID患者更高的治疗自主性，并促进其与医护人员的沟通。本研究旨在设计并开发一款面向IMID患者的远程监测与沟通类移动应用。
方法：本研究在某三级医院组建多学科团队，为IMID患者设计并开发一款移动应用。应用功能通过与IMID患者开展焦点小组访谈，以及对苹果应用商店（App Store）和谷歌应用商店（Play Store）上现有IMID相关应用的观察描述性研究确定。应用开发完成后，我们将其提供给启动新型生物疗法的IMID患者，纳入周期为2020年12月至2021年8月。本研究采用观察性纵向研究设计，评估该应用对用药安全性、沟通效率、患者满意度及易用性的影响。
结果：本研究开发了一款名为eMidCare®的移动应用，包含以下模块：我的用药（My Medication）、我的问卷（My Questionnaires）、不良事件（Adverse Events）、实用资讯（Useful Information）、消息沟通（Messages）及患者档案（Patient Profile）。最终共有85名患者安装使用该应用，患者使用该应用的中位随访时长为123（范围：5~270）天。在“我的用药”模块中，100%的患者登记了其接受的生物疗法，其中25.9%的患者还通过该模块记录了每次给药剂量。本研究共登记不良事件（adverse events, AEs）82例，32%的患者至少登记过1次不良事件。最常见的不良事件为疲劳、注射部位反应、头痛及恶心。52%的患者使用“消息沟通”模块与医护人员进行沟通，其中最常见的咨询内容为不良事件管理疑问（26.2%）及药物相互作用疑问（18.9%）。满意度调查结果显示，中位评分（范围）为9.1（7~10）分（满分10分）。
结论：本研究开发的eMidCare®应用可提醒患者按时服药，支持患者记录不良事件，并助力患者与医护人员开展沟通。约三分之一的患者登记了生物疗法给药情况且至少记录过1次不良事件。其中使用频率最高、满意度最佳的功能为与医护人员的沟通功能。