Effect of a Mobile Health App on Adherence to Physical Health Treatment: Retrospective Analysis

Abstract

Background Adherence to prescribed medical interventions can predict the efficacy of the treatment. In physical health clinics, not adhering to prescribed therapy can take the form of not attending a scheduled clinic visit (no-show appointment) or prematurely terminating treatment against the advice of the provider (self-discharge). A variety of interventions, including mobile phone apps, have been introduced for patients to increase their adherence to attending scheduled clinic visits. Limited research has examined the impact of a mobile phone app among patients attending chiropractic and rehabilitation clinic visits. Objective This study aims to compare adherence to prescribed physical health treatment among patients attending a chiropractic and rehabilitation clinic who did and did not choose to adopt a phone-based app to complement their treatment. Methods The medical records of new patients who presented for care during 2019 and 2020 at 5 community-based chiropractic and rehabilitation clinics were reviewed for the number of kept and no-show appointments and to determine whether the patient was provider-discharged or self-discharged. During this 24-month study, 36.28% (1497/4126) of patients seen in the targeted clinics had downloaded the Kanvas app on their mobile phone, whereas the remaining patients chose not to download the app (usual care group). The gamification component of the Kanvas app provided the patient with a point every time they attended their visits, which could be redeemed as an incentive. Results During both 2019 and 2020, the Kanvas app group was provider-discharged at a greater rate than the usual care group. The Kanvas app group kept a similar number of appointments compared with the usual care group in 2019 but kept significantly more appointments than the usual care group in 2020. During 2019, both groups exhibited a similar number of no-show appointments; however, in 2020, the Kanvas app group demonstrated more no-show appointments than the usual care group. When collapsed across years and self-discharged, the Kanvas app group had a greater number of kept appointments compared with the usual care group. When provider-discharged, both groups exhibited a similar number of kept appointments. The Kanvas app group and the usual care group were similar in the number of no-show appointments when provider-discharged, and when self-discharged, the Kanvas app group had more no-show appointments compared with the usual care group. Conclusions Patients who did or did not have access to the Kanvas app and were provider-discharged exhibited a similar number of kept appointments and no-show appointments. When patients were self-discharged and received the Kanvas app, they exhibited 3.2 more kept appointments and 0.94 more no-show appointments than the self-discharged usual care group.

Amputation Rates and Associated Social Determinants of Health in the Most Populous US Counties

“…While those studies were inconclusive on benefits to mortality and amputation reduction, meta-analyses assessing the benefits of exercise-based cardiac rehabilitation programs among patients with coronary artery disease have demonstrated reduction in cardiovascular mortality and risk of hospital admission . Studies also suggest a potential benefit of mobile-based exercise therapy programs in adherence, with resulting physical and psychological benefits . Additionally, in the present study, homicide rates also were associated with amputation rates in unadjusted analysis, suggesting a potential association of safety perception and engagement with physical exercise .…”

“…54 Studies also suggest a potential benefit of mobile-based exercise therapy programs in adherence, with resulting physical and psychological benefits. 55,56 Additionally, in the present study, homicide rates also were associated with amputation rates in unadjusted analysis, suggesting a potential association of safety perception and engagement with physical exercise. 26 The association between physical activity and amputation may also be attributable to surgeon decision-making, as ambulatory status is an important component of patient-centered limb preservation risk-benefit analysis.…”

Effect of electronic reminders on patients’ compliance during clear aligner treatment: an interrupted time series study

“…In addition to sending e-feedback and e-reminders to patients on regular basis, financial incentives were reported to enhance patient compliance 38 . In the context of the mobile application, a gaming component could be considered to further optimize compliance 39 , 40 . The efficacy of these methods in CAT patients needs to be further studied.…”

Evaluation of Patient-Facing Mobile Apps to Support Physiotherapy Care: Systematic Review

“…Facilitating positive behavior change in people with health conditions is often central to the management approach of physiotherapists, aimed at deriving the best possible therapeutic benefit from an intervention. For example, behavior change may be required for a person to follow physiotherapist advice regarding activity pacing or to adhere to exercise and physical activity recommendations [ 1 , 16 , 19 , 20 ]. BCTs can be thought of as the components of an intervention that regulate the behavior by altering cause and effect [ 21 ].…”