Personal digital program improves outcomes in long COVID, autoimmune disease
Click Here to Manage Email Alerts
Key takeaways:
- Patients with autoimmune disease or long COVIS who used the program experienced disease activity improvement.
- Patients entered data into the app on more than 80% of program days.
Patients with autoimmune diseases or long COVID who used a personalized digital care program alongside other non-pharmacologic strategies were more likely to achieve better health-related quality of life scores, according to data.
“The discovery of a truly effective diet and integrative intervention paradigm for [autoimmune diseases], particularly in patients who have atypical triggers and multiple sensitivities, requires an innovative approach, one that incorporates evidence based on personalized (‘N-of-1’) trials and takes individual immune system sensitivities and reactivities and each patient’s life circumstances into account,” Nicole Bundy, MD, the medical director at Mymee, a trial platform for patients with rheumatic diseases, and the lead study author, and colleagues wrote in RMD Open.
“This [digital care program (DCP)] relies on an individual’s self-reported, digitally tracked data (obtained via an adaptive mobile application [app]) and weekly remote health coaching to inform highly personalized diet and lifestyle interventions, which are monitored for efficacy and risks based on symptom response,” they added.
To assess the usefulness of a personalized digital care program (DCP) in improving patients’ health-related quality of life scores, Bundy and colleagues analyzed data from those who participated in the program between April 2020 and June 2022. Patients were included in the analysis if there was baseline and end-of-program data available. At the beginning of enrollment, patients completed an intake form that included demographic and clinical information. The intake form also asked about current symptoms, and answers were used to inform the symptom tracking functions of the application.
Throughout the course of the program, the health-related quality of life for each patient was evaluated across 10 domains. These included the ability to participate in social activities, cognitive function and the ability to manage one’s symptoms. Factors including physical function, anxiety, depression, fatigue and sleep quality were also measured. Bundy and colleagues assessed the feasibility of the app using engagement data from the application during the trial period.
Participants were trained on the use of the app, which included a compulsive food and drink tracking component, in addition to a tracking component for bowel movements. The app also made it possible for patients to track symptoms and environmental factors.
In all, the analysis included 202 patients aged 17 to 82 years, of whom 20.1% had rheumatoid arthritis, 14.9% had long COVID, 10.9% had psoriatic arthritis, 8.9% had psoriasis, 6.4% had systemic lupus erythematosus, 5.9% had inflammatory bowel disease, 5.9% had multiple sclerosis, and 5.4% had ankylosing spondylitis, while 23.3% reported “other” disease. On average, participants entered information into the app 7.6 times per day on 86% of the days measured.
According to the researchers, participants reported “statistically significant” improvements in all measured health-related quality of life domains, with patients demonstrating worse disease activity at baseline registering more improvement.
“This work demonstrates that a DCP is feasible and acceptable to a wide variety of individuals with [autoimmune diseases], [autoimmune disease]-related syndromes and long COVID,” Bundy and colleagues wrote. “The personalized interventions generated by the program were associated with statistically significant, clinically meaningful improvements in multiple domains germane to HRQoL as measured by PROMIS29+MSx.”
Collapse
Read more about
Click Here to Manage Email Alerts