A system incorporating a smartphone app might help adolescents and young adults with spina bifida improve their daily self-management skills, according to a pilot study of the interactive Mobile Health & Rehabilitation app.

OT_News-01Findings were published Oct. 20 in the American Journal of Physical Medicine & Rehabilitation.

With features including mobile reminders and messaging with healthcare providers, the iMHere system is feasible for use by young patients with spina bifida, according to the research by Brad E. Dicianno, MD, of the University of Pittsburgh Medical Center and colleagues including Andrea D. Fairman, PhD, OTR/L, CPRP, and Diane M. Collins PhD, OT.

“This system holds promise for use in many diverse chronic care models to support and increase self-management skills,” the researchers wrote.

The randomized pilot study evaluated the iMHere system in 23 patients, ages 18-40, who have spina bifida: a disabling congenital condition affecting the spine. The patients in the study had the most severe type — myelomeningocele.

One group of patients received the experimental iMHere system, which combined a suite of smartphone modules and a web-based portal for healthcare providers, linked by a two-way communication system. The modules were tailored to the key issues of spina bifida self-management, including information on medications, reminders to perform important daily self-care activities, and monitoring of mood and depression symptoms, according to a news release.

The other group of patients received routine spina bifida care and follow-up. After one year, researchers compared the use of the iMHere system and self-management skills between groups, along with other key outcomes.

Patients met or exceeded expected levels of use of the iMHere system, the study found. They were most likely to use modules that reminded them to perform self-care steps that occurred less than every day; and to remind them to take medications, which changed frequently, results showed. iMHere users “were also more likely to communicate new information or symptoms to a wellness coordinator by secure message, survey or photograph,” the authors wrote.

Researchers were surprised to find higher use of reminders did not decrease the rate of events requiring medical attention. However, the study showed patients who were high users of the iMHere system gained new independence in certain spina bifida self-management skills. All types of medical events tended to be less common for patients using iMHere, although the differences were not significant.

More than 166,000 Americans are living with spina bifida, most of them adults. This condition carries very high rates of complications related to bladder problems, skin wounds and infections. Past studies have estimated more than one-third of hospital admissions of adults with spina bifida are preventable.

Smartphones and other mobile health tools have the potential to improve self-management and health outcomes for patients with a wide range of chronic health conditions. According to the release, the study is one of the first to show the feasibility of using mobile tools to promote self-management skills and communication with healthcare providers for patients with chronic, disabling conditions such as spina bifida.

The preliminary results suggest the iMHere system might enable young patients — especially those who use the system frequently — to become more independent in managing their spina bifida.

“Additional refinements of the system are currently undergoing development in order to improve outcomes by increasing usage of each of the modules,” Dicianno and colleagues wrote in the article.

This study was funded by grants from the National Institute on Disability, Independent Living, and Rehabilitation Research, the Verizon Foundation and the National Institutes of Health.

Study abstract: http://journals.lww.com/ajpmr/Abstract/publishahead/Feasibility_of_Using_Mobile_Health_to_Promote.99003.aspx