Using technology to improve patient care

Patient‐centred technology, delivered via mobile phone apps, can dramatically improve patient outcomes

When you hear the word “telemedicine”, you probably think of sophisticated telesurgery and complicated, distance, computer‐enhanced teleconsultations.1 Telemedicine evokes thoughts of remote locations, with inadequate local services being augmented by involving experts who function or operate far from the location of the recipient of the service provided.1 This is no longer the case. Acknowledging that telemedicine includes technology used to improve health care delivery,2,3,4 its applications have become far more ubiquitous in everyday patient care.1,2,3,4

With the broad acceptance of mobile phones, the application of communications technology in medicine has expanded to include patient monitoring,4 recording the number of steps taken during the day,5 registering sleep patterns,6 and so much more. Programs have been prepared with the aim of optimising patient management, by helping patients with mandatory testing of blood parameters following therapies that can alter immunological responses, for instance.7

As part of this development, Chinese researchers in Chengdu, Sichuan Province, have developed a mobile phone application (app) with which they hope to improve patient self‐management of epilepsy (measured with the validated Chinese Epilepsy Self‐Management Scale, C‐ESMS8) and self‐reported seizure frequency.9 The app functions, developed in conjunction with the largest Chinese multipurpose messaging and social media company, include medication prompts, educational information, seizure monitoring, and surveys. In a randomised controlled study including almost 400 people, Si and colleagues tested the app in a sample of adults living in western China with active epilepsy of more than one year's duration, half of whom used the app and half did not. Data were collected by researchers blinded to whether individual participants were using the app; C‐ESMS score and seizure frequency were determined at baseline and after 6 months. Seizure reduction was categorised as no clear seizure reduction, 50–75% reduction, 75–100% reduction, or freedom from seizures at follow‐up. Other parameters, such as patient engagement, were also monitored in the app group; standard anti‐epileptic medication regimens were maintained throughout the study.

Almost 90% of the participants in both the app and control groups completed the study. Their demographic and clinical characteristics were similar at baseline. After 6 months, the mean C‐ESMS score for the active group had improved statistically and was also significantly different from that of the control group; further, larger proportions of the app group reported complete seizure freedom or at least 75% reduction in seizure frequency, although there was no direct correlation between seizure frequency and change in C‐ESMS score.

These results confirm the direct benefits of adopting a patient‐centred intervention, such as a mobile phone app, to enable people with epilepsy to be more involved in their own care, improving seizure control without altering their pharmacologic treatment. Lack of correlation between C‐ESMS and seizure frequency justifies closer investigation; it is possible that the app also served as a motivator of greater compliance and adherence to therapy, and of more diligent attention to lifestyle factors that were not specifically monitored during the study.

The study by Si and colleagues adds weight to the growing evidence that patient‐centred technology, delivered via mobile phone applications, can dramatically improve patient outcomes. Well designed studies, especially controlled trials, support the benefits that accrue from the wider application of telemedicine in its broadest sense.

Competing interest

No relevant disclosures.