Fabry App: the value of a portable technology in recording day-to-day patient monitored information in patients with Fabry disease

Abstract Background Fabry disease is a rare inherited disorder resulting from deficient α-galactosidase A enzyme activity. Common disease manifestations are sweating abnormalities, neuropathic pain, gastrointestinal symptoms and fatigue. Challenges are faced by health care professionals in evaluatin...

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Main Authors: Simona D’Amore, Mark Mckie, Andrew Fahey, David Bleloch, Giuseppina Grillo, Michael Hughes, Uma Ramaswami
Format: Article
Language:English
Published: BMC 2024-01-01
Series:Orphanet Journal of Rare Diseases
Subjects:
Online Access:https://doi.org/10.1186/s13023-023-02999-6
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author Simona D’Amore
Mark Mckie
Andrew Fahey
David Bleloch
Giuseppina Grillo
Michael Hughes
Uma Ramaswami
author_facet Simona D’Amore
Mark Mckie
Andrew Fahey
David Bleloch
Giuseppina Grillo
Michael Hughes
Uma Ramaswami
author_sort Simona D’Amore
collection DOAJ
description Abstract Background Fabry disease is a rare inherited disorder resulting from deficient α-galactosidase A enzyme activity. Common disease manifestations are sweating abnormalities, neuropathic pain, gastrointestinal symptoms and fatigue. Challenges are faced by health care professionals in evaluating symptom burden in the current clinical setting, and the demand for alternative methods for monitoring disease-specific symptoms has seen an acceleration in recent years. Smartphone technologies offer the potential for continuity of care and surveillance. As a part of a quality improvement project, a disease specific app was developed in collaboration with a software company (Health Touch Ltd) and made available for patient use in May 2018. The Fabry mobile app records five categories: pain, gastrointestinal symptoms, sweating, activity levels, medications. Fabry disease patients with gastrointestinal and pain symptoms attending the Lysosomal Storage Disorders Unit of the Royal Free London NHS Foundation Trust were reviewed to assess eligibility and invited to download the app for recording their symptoms (activity, sweating, pain and gastrointestinal) and medications. Patient-generated data were transmitted to a secure website for clinicians to review. Results One-hundred and thirty-nine symptomatic Fabry disease patients who had a smartphone (iPhone or android) were invited to download the app. Sixty-seven patients (26 males and 41 females; median age, 49 years [range, 20–81]) downloaded and tracked the Fabry App at least once. The median frequency of use per patient was 6 (range, 1–629). Pain in the hands and abdominal pain were significantly higher (p = 0.009 and p = 0.007, respectively) in patients with classic phenotype compared with patients with non-classic phenotypes. Conclusions We demonstrated the feasibility and acceptability of a smartphone app to facilitate the remote assessment and monitoring of Fabry disease symptom burden on a daily/weekly basis, as an alternative to the current standard of care that requires patients to recall their symptoms during 6 to 12 monthly annual clinic visits. Patients who were more likely to use the app had greater disease burden. This innovation has the potential to assess disease progression, early therapeutic intervention, thereby decreasing the burden of morbidity and mortality among Fabry patients, and to record long-term effects of Fabry-specific therapies.
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spelling doaj.art-1d51f47fe2a84c218dc39c32efe68f032024-01-14T12:36:17ZengBMCOrphanet Journal of Rare Diseases1750-11722024-01-0119111010.1186/s13023-023-02999-6Fabry App: the value of a portable technology in recording day-to-day patient monitored information in patients with Fabry diseaseSimona D’Amore0Mark Mckie1Andrew Fahey2David Bleloch3Giuseppina Grillo4Michael Hughes5Uma Ramaswami6Lysosomal Storage Disorders Unit, Royal Free Hospital NHS Foundation TrustLysosomal Storage Disorders Unit, Royal Free Hospital NHS Foundation TrustHealthTouch LtdLysosomal Storage Disorders Unit, Royal Free Hospital NHS Foundation TrustLysosomal Storage Disorders Unit, Royal Free Hospital NHS Foundation TrustHealthTouch LtdLysosomal Storage Disorders Unit, Royal Free Hospital NHS Foundation TrustAbstract Background Fabry disease is a rare inherited disorder resulting from deficient α-galactosidase A enzyme activity. Common disease manifestations are sweating abnormalities, neuropathic pain, gastrointestinal symptoms and fatigue. Challenges are faced by health care professionals in evaluating symptom burden in the current clinical setting, and the demand for alternative methods for monitoring disease-specific symptoms has seen an acceleration in recent years. Smartphone technologies offer the potential for continuity of care and surveillance. As a part of a quality improvement project, a disease specific app was developed in collaboration with a software company (Health Touch Ltd) and made available for patient use in May 2018. The Fabry mobile app records five categories: pain, gastrointestinal symptoms, sweating, activity levels, medications. Fabry disease patients with gastrointestinal and pain symptoms attending the Lysosomal Storage Disorders Unit of the Royal Free London NHS Foundation Trust were reviewed to assess eligibility and invited to download the app for recording their symptoms (activity, sweating, pain and gastrointestinal) and medications. Patient-generated data were transmitted to a secure website for clinicians to review. Results One-hundred and thirty-nine symptomatic Fabry disease patients who had a smartphone (iPhone or android) were invited to download the app. Sixty-seven patients (26 males and 41 females; median age, 49 years [range, 20–81]) downloaded and tracked the Fabry App at least once. The median frequency of use per patient was 6 (range, 1–629). Pain in the hands and abdominal pain were significantly higher (p = 0.009 and p = 0.007, respectively) in patients with classic phenotype compared with patients with non-classic phenotypes. Conclusions We demonstrated the feasibility and acceptability of a smartphone app to facilitate the remote assessment and monitoring of Fabry disease symptom burden on a daily/weekly basis, as an alternative to the current standard of care that requires patients to recall their symptoms during 6 to 12 monthly annual clinic visits. Patients who were more likely to use the app had greater disease burden. This innovation has the potential to assess disease progression, early therapeutic intervention, thereby decreasing the burden of morbidity and mortality among Fabry patients, and to record long-term effects of Fabry-specific therapies.https://doi.org/10.1186/s13023-023-02999-6Fabry diseaseSmartphone applicationsPatient reported dataDisease monitoringDisease management
spellingShingle Simona D’Amore
Mark Mckie
Andrew Fahey
David Bleloch
Giuseppina Grillo
Michael Hughes
Uma Ramaswami
Fabry App: the value of a portable technology in recording day-to-day patient monitored information in patients with Fabry disease
Orphanet Journal of Rare Diseases
Fabry disease
Smartphone applications
Patient reported data
Disease monitoring
Disease management
title Fabry App: the value of a portable technology in recording day-to-day patient monitored information in patients with Fabry disease
title_full Fabry App: the value of a portable technology in recording day-to-day patient monitored information in patients with Fabry disease
title_fullStr Fabry App: the value of a portable technology in recording day-to-day patient monitored information in patients with Fabry disease
title_full_unstemmed Fabry App: the value of a portable technology in recording day-to-day patient monitored information in patients with Fabry disease
title_short Fabry App: the value of a portable technology in recording day-to-day patient monitored information in patients with Fabry disease
title_sort fabry app the value of a portable technology in recording day to day patient monitored information in patients with fabry disease
topic Fabry disease
Smartphone applications
Patient reported data
Disease monitoring
Disease management
url https://doi.org/10.1186/s13023-023-02999-6
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