Background/Purpose:

Some of the challenges facing patients with chronic diseases such as systemic lupus erythematosus (SLE) include identifying triggers for disease “flares” and accurately recalling medication changes they make in response to flares, e.g, self-adjustments of daily prednisone doses. We sought to assess interest in and applicability of smartphone technology as a convenient tool for disease self-management, as well as assessing usage patterns among a heterogeneous group of lupus patients at an academic outpatient clinic. These data will inform the design of a mobile application (“app”), a feature of which will allow SLE patients to conveniently and accurately record disease activity trends and prednisone use over time between rheumatology clinic appointments.

Methods: Lupus patients from the University of Michigan rheumatology clinics who met ≥4 ACR criteria and age ≥18 years.  Participants completed a survey containing questions on sociodemographics, healthcare information needs and satisfaction, and access to technology, including smartphone usage patterns. Multivariable logistic regression was used to examine the likelihood of mobile app use among three indicators of socioeconomic status, adjusting for age, sex and race.

Results: Among 100 SLE patient respondents, demographics were:  89% female, mean age 40 years (SD 13); race 66% white, 21% black, 13% other/unknown.; education 16% ≤high school, 34% some college or technical school, 16% college graduate, 33% graduate degree;  insurance coverage 23% Medicaid/none, 12% Medicare; 65% private.  Participants expressed high interest in a mobile app for lupus:  70% rate app usage would be “extremely helpful” (5 on a 1-5 scale) as a “simple way to get in touch with your healthcare team.”  The majority reported the following mobile app features would be “extremely helpful”:   automatic reminders (60%), ability to track flares & triggers of disease activity (59%), and sharing this information with healthcare providers (58%).  Younger age was associated with increased mobile app usage:  95% among 20-29 yrs, 73% among 30-49 yrs, 22% among  ≥50 yrs (OR for 10 yr interval 0.31, 95%CI 0.2-0.5).  When adjusted for age, sex, and race, mobile app usage was similar according to education level (all p=NS).  According to type of insurance coverage, those with Medicaid/none reported less mobile app use compared to privately insured (OR 0.16, 95% CI 0.03, 0.86), while those with Medicare were comparable to private (OR 0.77, 95% CI 0.14, 4.3). 

Conclusion: These data reveal broad interest in a mobile app for lupus, including proposed features for disease management, across sociodemographic groups.  The majority of respondents use smartphone/mobile app technology, with younger age being a significant predictor.  However, across different indicators of socioeconomic status, various usage patterns emerge.  These data can be used to help target efforts to increase accessibility to this technology.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/access-to-technology-and-interest-in-mobile-app-for-disease-management-among-patients-with-systemic-lupus-erythematosus-seeking-care-at-a-large-referral-center/