Background Menstrual apps facilitate observation and analysis of menstrual cycles and associated factors through the collection and interpretation of data entered by users. As a subgroup of health-related apps, menstrual apps form part of one of the most dynamic and rapidly growing developments in biomedicine and health care. However, despite their popularity, qualitative research on how people engaging in period-tracking use and experience these apps remains scarce. Methods Between June 2016 and March 2017, we conducted 26 qualitative interviews with menstrual app users living in Austria and Spain. The participants were asked about their practices and experiences regarding app-supported menstrual tracking. The interviews were audio recorded, transcribed verbatim, and coded using the software NVivo. Results An inductive content analysis was performed and eight characteristics of app-supported menstrual tracking were identified: 1) tracking menstrual cycle dates and regularities, 2) preparing for upcoming periods, 3) getting to know menstrual cycles and bodies, 4) verifying menstrual experiences and sensations, 5) informing healthcare professionals, 6) tracking health, 7) contraception and seeking pregnancy, and 8) changes in tracking. Our study finds that period-tracking via apps has the potential to be an empowering practice as it helps users to be more aware of their menstrual cycles and health and to gain new knowledge. However, we also show that menstrual tracking can have negative consequences as it leads to distress in some cases, to privacy issues, and the work it requires can result in cessation. Finally, we present practical implications for healthcare providers and app developers. Conclusions This qualitative study gives insight into users’ practices and experiences of app-supported menstrual tracking. The results provide information for researchers, health care providers and app designers about the implications of app-supported period-tracking and describe opportunities for patient-doctor interactions as well as for further development of menstrual apps.

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Objectives: Real world sick funds data in Germany were used to reveal the treatment patterns for Diffuse Large B-cell Lymphoma (DLBCL) and to identify unmet medical needs. Methods: In two independent cohorts of German claims data 819 and 189 DLBCL patients were identified and diagnoses, hospitalization, medication and health costs were analyzed for at least two consecutive years between 2013 and 2016. Results: In the first [second] cohort, mean age of DLBCL patients was 60.3 [66.5] years, with two peaks at 50-54 and 70-74 years. Total annual health care costs for DLBCL patients ranged from 25,000 to 60,000 EUR versus 1,259 EUR in healthy insured. Per year, mean 3.2 [3.5] hospitalizations with an average of 31.5 [34.5] hospital days were observed. During the observation period less than half of the DLBCL patients received oncological treatment and only few patients received stem cell transplantation or radiation. Most frequent pharmacological first line treatments were Rituximab (RTX) + CHOP (57%, [56%]) and RTX in combination with Bendamustine (8%, [7%]). In both analyses consistently 84% of patients did not receive further therapies after a first line DLBCL treatment during the limited observation period. Conclusions: Despite limitations in sick fund claims analyses, these databases are a reasonable source for real world evidence (RWE) of rare diseases. Both cohorts were well in agreement and revealed standard treatment pathways consistent with the German treatment guidelines. All DLBCL patients frequently required hospitalization and generated significant costs. A high unmet medical need exists for treatments other than palliative care, especially for a tolerable and effective outpatient therapy in elderly relapsed / refractory DLBCL patients.

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