Abstract

BackgroundGout is a form of chronic arthritis caused by elevated serum uric acid (SUA) and culminates in painful gout attacks. Although effective uric acid-lowering therapies exist, adherence is low. This is partly due to the lack of support for patients to self-manage their disease. Mobile health apps have been used in the self-management of chronic conditions. However, not all are developed with patients, limiting their effectiveness.ObjectiveThe objective of our study was to collect feedback from gout patients to design an effective gout self-management app.MethodsTwo descriptive qualitative studies were conducted. In Study 1, researchers developed a short educational video and written materials about gout management, designed to be embedded into an app; 6 interviews and 1 focus group were held with gout patients to gather feedback on these materials. Usability testing in Study 2 involved additional gout patients using a pilot version of Healthy.me Gout, a gout self-management app, for 2 weeks. Following the trial, patients participated in an interview about their experiences using the app.ResultsPatients viewed the gout educational material positively, appreciating the combined use of video, text, and images. Patients were receptive to using a mobile app to self-manage their gout. Feedback about Healthy.me Gout was generally positive with patients reporting that the tracking and diary features were most useful. Patients also provided suggestions for improving the app and educational materials.ConclusionsThese studies involved patients in the development of a gout self-management app. Patients provided insight to improve the app’s presentation and usability and general lessons on useful features for chronic disease apps. Gout patients enjoyed tracking their SUA concentrations and gout attack triggers. These capabilities can be translated into self-management apps for chronic diseases that require monitoring of pathological values, medication adherence, or symptoms. Future health app design should integrate patient input and be developed iteratively to address concerns identified by patients.

Highlights

  • MethodsMobile health technologies present opportunities for improving patient self-management of chronic diseases [1,2]

  • Gout patients enjoyed tracking their serum uric acid (SUA) concentrations and gout attack triggers. These capabilities can be translated into self-management apps for chronic diseases that require monitoring of pathological values, medication adherence, or symptoms

  • 11 gout patients participated in Study 1, at which point theme saturation was reached; 5 patients were recruited via their general practitioners, and 6 responded to flyers

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Summary

Introduction

MethodsMobile health (mHealth) technologies present opportunities for improving patient self-management of chronic diseases [1,2]. Gout is a chronic form of arthritis that causes a significant health burden worldwide [7] It results from elevated serum uric acid (SUA) concentrations and culminates in debilitating gout attacks [8-10]. An intervention that was delivered by nurses comprised personalized education, lifestyle advice, and appropriate prescribing of ULTs resulted in 92% of patients achieving target SUA concentrations 1-year post intervention [14]. Effective, this intervention was very labor and resource intensive and unlikely to be sustainable in the long term. Effective uric acid-lowering therapies exist, adherence is low This is partly due to the lack of support for patients to self-manage their disease. Not all are developed with patients, limiting their effectiveness

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