Engagement, Retention, and Acceptability in a Digital Health Program for Atopic Dermatitis: Prospective Interventional Study

• Published in: JMIR Formative Research
• Main Authors: Gudmundsdóttir, Sigrídur Lára, Ballarini, Tommaso, Ámundadóttir, María L, Mészáros, Judit, Eysteinsdottir, Jenna Huld, Thorleifsdottir, Ragna H, Hrafnkelsdóttir, Sigrídur K, Helgadottir, Halla, Oddsson, Saemundur, Silverberg, Jonathan I
• Format: Text
• Language: English
• Published: JMIR Publications 2023
• Subjects: Original Paper; Iceland
• Online Access: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10337350/; http://www.ncbi.nlm.nih.gov/pubmed/36975050; https://doi.org/10.2196/41227

BACKGROUND: Patients with atopic dermatitis can experience chronic eczema with pruritus, skin pain, sleep problems, anxiety, and other problems that reduce their quality of life (QoL). Current treatments aim to improve these symptoms and reduce inflammation, but poor treatment adherence and disease understanding are key concerns in the long-term management of atopic dermatitis. Digital therapeutics can help with these and support patients toward a healthier lifestyle to improve their overall QoL. OBJECTIVE: The aim of the study is to test the feasibility of a digital health program tailored for atopic dermatitis through program engagement, retention, and acceptability. METHODS: Adults with atopic dermatitis were recruited in Iceland for a 6-week digital health program delivered through a smartphone app. Key components of the digital program were disease and trigger education; medication reminders; patient-reported outcomes (PROs) on energy levels, stress levels, and quality of sleep (referred to as QoL PROs); atopic dermatitis symptom PROs; guided meditation; and healthy lifestyle coaching. The primary outcome was program feasibility, as assessed by in-app retention and engagement. User satisfaction was assessed by the mHealth (ie, mobile health) App Usability Questionnaire (MAUQ). RESULTS: A total of 21 patients were recruited (17 female, mean age 31 years), 20 (95%) completed the program. On average, users were active in the app 6.5 days per week and completed 8.2 missions per day. The education content, medication reminders, and PROs had high user engagement and retention; all users who were exposed to the QoL PROs (n=17) interacted with these, and 20/21 (95%) users were continuously engaged with the education missions, medication missions, and symptom PROs. Continued engagement with the step counter and mind missions among exposed users was lower (17/21 and 13/20 participants, respectively). Medication reminder and education task completion remained high over time (at least 18/20, 90%), but weekly ...