Zvulunov Alex, Lenevich Stepan, Migacheva Natalia
Sheba Medical Center, Reichman University, Herzliya, Ramat Gan, Israel.
AvantaTrading Ltd, Moscow, Russian Federation.
JMIR Dermatol. 2023 Dec 13;6:e49278. doi: 10.2196/49278.
Inadequate control of atopic dermatitis (AD) increases the frequency of exacerbations and reduces the quality of life. Mobile health apps provide information and communication technology and may increase treatment adherence and facilitate disease management at home. The mobile health app, Atopic App, designed for patients and their caregivers, and the associated web-based patient education program, Atopic School, provide an opportunity for improving patients' and caregivers' engagement and adherence to the management of AD.
This noninterventional, observational study aimed to explore the feasibility and potential impact on the management of AD in children by caregivers using the Atopic App mobile health app.
The patient-oriented eczema measure (POEM) and numerical rating scale for the grading of pruritus were used as severity scores (scale range: 0-28). The artificial intelligence model of the app was used to assess the severity of AD based on the eczema area and severity index approach. The deidentified data enabled the analysis of the severity of AD, treatment plan history, potential triggers of flare-ups, usage of available features of the app, and the impact of patient education.
During a 12-month period, of the 1223 users who installed the app, 910 (74.4%) registered users were caregivers of children with AD. The web-based Atopic School course was accessed by 266 (29.2%) caregivers of children with AD, 134 (50.4%) of whom completed the course. Usage of the app was significantly more frequent among those who completed the Atopic School program than among those who did not access or did not complete the course (P<.001). Users who completed a second POEM 21 to 27 days apart exhibited a significant improvement of AD severity based on the POEM score (P<.001), with an average improvement of 3.86 (SD 6.85) points. The artificial intelligence severity score and itching score were highly correlated with the POEM score (r=0.35 and r=0.52, respectively).
The Atopic App provides valuable real-world data on the epidemiology, severity dynamics, treatment patterns, and exacerbation-trigger correlations in patients with AD. The significant reduction in the POEM score among users of the Atopic App indicates a potential impact of this tool on health care engagement by caregivers of children with AD.
特应性皮炎(AD)控制不佳会增加病情加重的频率并降低生活质量。移动健康应用程序提供信息和通信技术,可能会提高治疗依从性并便于在家中进行疾病管理。专为患者及其护理人员设计的移动健康应用程序Atopic App以及相关的基于网络的患者教育计划Atopic School,为改善患者及其护理人员对AD管理的参与度和依从性提供了机会。
这项非干预性观察性研究旨在探讨护理人员使用Atopic App移动健康应用程序对儿童AD管理的可行性和潜在影响。
以患者为导向的湿疹测量(POEM)和瘙痒分级数字评定量表用作严重程度评分(量表范围:0-28)。该应用程序的人工智能模型用于根据湿疹面积和严重程度指数方法评估AD的严重程度。经过去识别化处理的数据可用于分析AD的严重程度、治疗计划历史、发作的潜在触发因素、应用程序可用功能的使用情况以及患者教育的影响。
在12个月期间,在1223名安装了该应用程序的用户中,910名(74.4%)注册用户是AD患儿的护理人员。266名(29.2%)AD患儿的护理人员访问了基于网络的Atopic School课程,其中134名(50.4%)完成了该课程。完成Atopic School计划的人员使用该应用程序的频率明显高于未访问或未完成该课程的人员(P<0.001)。在间隔21至27天完成第二次POEM的用户中,基于POEM评分,AD严重程度有显著改善(P<0.001),平均改善3.86(标准差6.85)分。人工智能严重程度评分和瘙痒评分与POEM评分高度相关(分别为r=0.35和r=0.52)。
Atopic App提供了关于AD患者的流行病学、严重程度动态、治疗模式以及发作触发因素相关性的宝贵真实世界数据。Atopic App用户的POEM评分显著降低表明该工具对AD患儿护理人员参与医疗保健有潜在影响。