A randomized trial, published in JMIR mHealth and uHealth, reported significant benefits of combining an education program and disease management smartphone app for improving the mental health of patients with psoriasis. Co-lead authors, Lena Domogalla and Alena Beck from the Department of Dermatology at the University Medical Center Mannheim of Heidelberg University, noted that while these treatment plans are common in routine care of other diseases, “such disease management strategies are lacking in the routine care of patients with psoriasis.”

The primary endpoint was significant reduction of Hospital Anxiety and Depression Scale (HADS) scores. Secondary end points included improvements in Dermatology Life Quality Index scores, Psoriasis Area and Severity Index scores, pruritus, pain, as well as mood and daily activities. Modulating effects of sex, age, disease duration, and app use frequency were evaluated.

A total of 107 patients were enrolled, and 77 completed the study. Investigators reported a significant reduction in HADS-Depression (HADS-D) scores in the intervention group at 12 (p = 0.04), and 24 weeks (p = 0.005), but not at 36 (p = 0.12) and 60 weeks (p = 0.32).

Patients using the app less than once every five weeks showed significant improvements in HADS-D score at 36 weeks (p = 0.004) and 60 weeks (p = 0.04) and HADS-Anxiety (HADS-A) score at 36 weeks (p = 0.04) and 60 weeks (p = 0.05) in the group. Notably, in patients using the app more than once every five weeks, no significant improvements in HADS-D (p =0 .84) or HADS-A (p = 0.20) scores were observed relative to improvements shown in the control group.

Authors listed the monocentric design, small sample size, and limited generalizability of the results as limitations of the study, and further specified that “the number of patients in the subgroups divided by app use frequency was quite low, which could have led to missed or overinterpreted differences between the groups.”

The study’s findings provide support for the use of a disease management app to improve mental health of patients with psoriasis, so long as it is not used too frequently, according to the authors. They suggested future research investigates the new variable of app use frequency.


Source: JMIR mHealth and uHealth