Assessment of a Mobile Health iPhone App for Semiautomated Self-management of Chronic Recurrent Medical Conditions Using an N-of-1 Trial Framework: Feasibility Pilot Study

Archana Mande; Susan L Moore; Farnoush Banaei-Kashani; Benjamin Echalier; Sheana Bull; Michael A Rosenberg

doi:10.2196/34827

Assessment of a Mobile Health iPhone App for Semiautomated Self-management of Chronic Recurrent Medical Conditions Using an N-of-1 Trial Framework: Feasibility Pilot Study

JMIR Form Res. 2022 Apr 12;6(4):e34827. doi: 10.2196/34827.

Authors

Archana Mande¹, Susan L Moore², Farnoush Banaei-Kashani³, Benjamin Echalier⁴, Sheana Bull², Michael A Rosenberg¹

Affiliations

¹ Division of Personalized Medicine and Biomedical Informatics, University of Colorado Anschutz Medical Campus, Aurora, CO, United States.
² mHealth Impact Laboratory, University of Colorado Anschutz Medical Campus, Aurora, CO, United States.
³ College of Engineering and Applied Science, University of Colorado Denver, Denver, CO, United States.
⁴ Clinical Research Support Team, University of Colorado Anschutz Medical Campus, Aurora, CO, United States.

PMID: 35412460
PMCID: PMC9044158
DOI: 10.2196/34827

Abstract

Background: Management of chronic recurrent medical conditions (CRMCs), such as migraine headaches, chronic pain, and anxiety/depression, remains a major challenge for modern providers. Our team has developed an edge-based, semiautomated mobile health (mHealth) technology called iMTracker that employs the N-of-1 trial approach to allow self-management of CRMCs.

Objective: This study examines the patterns of adoption, identifies CRMCs that users selected for self-application, and explores barriers to use of the iMTracker app.

Methods: This is a feasibility pilot study with internet-based recruitment that ran from May 15, 2019, to December 23, 2020. We recruited 180 patients to pilot test the iMTracker app for user-selected CRMCs for a 3-month period. Patients were administered surveys before and after the study.

Results: We found reasonable usage rates: a total of 73/103 (70.9%) patients who were not lost to follow-up reported the full 3-month use of the app. Most users chose to use the iMTracker app to self-manage chronic pain (other than headaches; 80/212, 37.7%), followed by headaches in 36/212 (17.0%) and mental health (anxiety and depression) in 27/212 (12.8%). The recurrence rate of CRMCs was at least weekly in over 93% (169/180) of patients, with 36.1% (65/180) of CRMCs recurring multiple times in a day, 41.7% (75/180) daily, and 16.1% (29/180) weekly. We found that the main barriers to use were the design and technical function of the app, but that use of the app resulted in an improvement in confidence in the efficiency and safety/privacy of this approach.

Conclusions: The iMTracker app provides a feasible platform for the N-of-1 trial approach to self-management of CRMCs, although internet-based recruitment provided limited follow-up, suggesting that in-person evaluation may be needed. The rate of CRMC recurrence was high enough to allow the N-of-1 trial assessment for most traits.

Keywords: chronic disease; facilitators and barriers; implementation and deployment; mHealth; patient-specific modeling; smartphone.

©Archana Mande, Susan L Moore, Farnoush Banaei-Kashani, Benjamin Echalier, Sheana Bull, Michael A Rosenberg. Originally published in JMIR Formative Research (https://formative.jmir.org), 12.04.2022.

Abstract

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