Mobile health technology: a novel tool in chronic disease management

The successful control of chronic diseases mainly depends on how well patients manage their disease conditions with the aid of healthcare providers.Mobile health technology—also known as mHealth—supports healthcare practice by means of mobile devices such as smartphone applications,web-based technologies,telecommunications services,social media,and wearable technology,and is becoming increasingly popular.Many studies have evaluated the utility of mHealth as a tool to improve chronic disease management through monitoring and feedback,educational and lifestyle interventions,clinical decision support,medication adherence,risk screening,and rehabilitation support.The aim of this article is to summarize systematic reviews addressing the effect of mHealth on the outcome of patients with chronic diseases.We describe the current applications of various mHealth approaches,evaluate their effectiveness as well as limitations,and discuss potential challenges in their future development.The evidence to date indicates that none of the existing mHealth technologies are inferior to traditional care.Telehealth and web-based technologies are the most frequently reported interventions,with promising results ranging from alleviation of disease-related symptoms,improvement in medication adherence,and decreased rates of rehospitalization and mortality.The new generation of mHealth devices based on various technologies are likely to provide more efficient and personalized healthcare programs for patients.

Assessment of a Downloadable Application with Avatar Guidance for PT-Prescribed Home Exercise after Total Knee Arthroplasty: A 30-Day Usability and Feasibility Study

Objective: To explore the usability and feasibility of a downloadable application (APP) compared to paper handouts (CONTROL) in guiding 30 days of PT-prescribed home exercise after total knee arthroplasty (TKA), and to compare functional outcomes at 30 days postoperatively between APP and CONTROL. Design: Randomized controlled usability and feasibility study. Setting: Rehabilitation laboratories at two regional medical centers. Participants: Individuals with knee osteoarthritis undergoing unilateral TKA (APP group: N = 26;mean age, 67.0 ± 8.2 y;CONTROL group: N = 31;mean age, 64.7 ± 7.7 y). Interventions: This study assessed the user experience of a downloadable app to guide 30 days of home exercises and instruction after TKA and compared exploratory outcomes to a group using paper handouts. Main Outcome Measures: The System Usability Scale (SUS) score was used to assess patient usability experience. Raw SUS scores were dichotomized (≥72% or <72%) to determine app usability against a 75% a priori criterion for mean APP group score. Feasibility for app use was similarly evaluated in the APP group only through a priori criteria applied to computing device ownership and study use, to the absence of technology-based barriers to participation, and to completion of app-based testing. Exploratory measures compared change from baseline to 30 days for functional and patient-reported outcomes between APP and CONTROL. Results: The APP group’s mean SUS score of 79.2% at 30 days exceeded the 75% threshold for good usability. The app met the predetermined a priori feasibility criteria for absence of technology-based barriers to participation (75% of participants) and completion of app-based testing (91.3% of participants). Personal computing devices were used by 71.4% of APP participants, which was below the 75% a priori feasibility criterion. No differences between the APP and CONTROL groups were observed for functional or patient-reported outcomes. Conclusions: The app-based platform met the a priori criteria for usability for 79% of APP participants. Our findings suggest that app-based, avatar-guided home exercise after TKA has acceptable usability and feasibility. The app-guided patient assessment capability also demonstrates preliminary feasibility for guiding and administering functional and self-reported outcomes assessments.