Abstract 11: Patters and Predictors of Persistent Use of a Post-Discharge Mobile Application to Improve Care and Outcomes Among Stroke Patients

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Abstract

Introduction: There are relatively few published data on the use of mobile technology to enhance post-stroke care and outcomes. Information on the utility and key characteristics of mobile health applications (APPS) in the post-discharge care of stroke patients could inform their successful implementation into routine clinical practice.

Objective: To identify the patterns and predictors of high usage of a mobile care APP among recently discharged stroke patients.

Methods: Of 1817 patients consecutively encountered at a single academic medical center from August 2016 to April 2017, 471 (25.9%) stroke patients discharged from the hospital were given use of a mobile medical application for a period of 3 months. The status of the usage and the preferences setting of APP were recorded. Demographic characteristics, medical history, stroke related information were summarized. Persistent/high usage was defined as 80% of time for usage. Relevant factors associated with the usage of APP were analyzed with a multiple regression.

Results: 176 out of 471 (37.4%) patients persistently used the APP during the study period. Health education (91.3%), self-monitoring comprising blood pressure and blood glucose modules (77.1%) and nurse consultation (60.1%) were the top three commonly used modules. Multivariate analysis showed that younger age (p=0.010), higher education (p=0.000), history of hypertension (p=0.011), diabetes (p=0.000), and stroke (p=0.026), and non-drinker (p=0.023) were significantly associated with persistent use of the APP.

Conclusion: We found that only one out of 3 stroke patients in this cohort persistently utilized our post-discharge mobile APP. Our data suggest that either such apps should focus primarily on patient groups most likely to persistently use them or specific interventions may need to be developed to facilitate greater use among low users.

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