Applications and barriers to use of an mHealth iPhone application for self-management of chronic recurrent medical conditions: A Pilot Study

Management of chronic recurrent medical conditions (CRMC), such as migraine headaches, chronic pain and anxiety/depression, is a major challenge for modern providers. The fact that often the most effective treatments and/or preventative measures for CRMCs vary from patient to patient lends itself to a platform for self-management by patients. However, to develop such an mHealth app requires an understanding of the various applications, and barriers, to real-world use. In this pilot study with internet-based recruitment, we conducted an assessment of user satisfaction of the iMTracker iOS (iPhone) application for CRMC self-management through a self-administered survey of subjects with CRMCs. From May 15, 2019 until March 27, 2020, we recruited 135 subjects to pilot test the iMTracker application for user-selected CRMCs. The most common age group was 31–45 (48.2%), followed by under 30 (22.2%) and 46–55 (20%). There were no subjects over 75 years old completing the survey. 38.8% of subjects were college graduates, followed by 29.6% with a Master’s degree, and 25.9% with some college. No subjects had not graduated from high school, and only 2 (1.5%) did not attend college after high school. 80.7% of subjects were self-identified as Caucasian, and 90.4% as not Hispanic or Latino. The most common CRMC was pain (other than headaches) in 40% of subjects, followed by mental health in 17.8% and headaches in 15.6%. 39.3% of subjects experienced the condition multiple times in a day, 40.0% experienced the condition daily, and 14.8% experienced the condition weekly, resulting in a total of 94.1% of subjects experiencing the condition at least weekly. Among the concerns about a self-management app, time demands (54.8%) and ineffectiveness (43.7%) were the most prominent, with privacy (24.4%) and data security (25.2%) also noted. In summary, we found internet-based recruitment identified primarily Caucasian population of relatively young patients with CRMCs of relatively high recurrence rate. Future work is needed to examine the use of this application in older, underrepresented minorities, and lower socioeconomic status populations. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This research was supported by grants from the NIH/NHBLI (MR: K23HL127296). ### Author Declarations All relevant ethical guidelines have been followed; any necessary IRB and/or ethics committee approvals have been obtained and details of the IRB/oversight body are included in the manuscript. Yes All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes Data will be made available upon request and approval by the University of Colorado Multiple IRB (COMIRB)