Narrowing the Patient–Physician Gap Based on Self-Reporting and Monthly Hepatologist Feedback for Patients With Alcohol-Related Liver Disease: Interventional Pilot Study Using a Journaling Smartphone App
BackgroundScreening and intervention for alcohol use disorders (AUDs) are recommended to improve the prognosis of patients with alcohol-related liver disease (ALD). Most patients’ smartphone app diaries record drinking behavior for self-monitoring. A smartphone app can be exp...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JMIR Publications
2023-12-01
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| Series: | JMIR Formative Research |
| Online Access: | https://formative.jmir.org/2023/1/e44762 |
| _version_ | 1797385909147009024 |
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| author | Noriyo Yamashiki Kyoko Kawabata Miki Murata Shunichiro Ikeda Takako Fujimaki Kanehiko Suwa Toshihito Seki Eiji Aramaki Makoto Naganuma |
| author_facet | Noriyo Yamashiki Kyoko Kawabata Miki Murata Shunichiro Ikeda Takako Fujimaki Kanehiko Suwa Toshihito Seki Eiji Aramaki Makoto Naganuma |
| author_sort | Noriyo Yamashiki |
| collection | DOAJ |
| description |
BackgroundScreening and intervention for alcohol use disorders (AUDs) are recommended to improve the prognosis of patients with alcohol-related liver disease (ALD). Most patients’ smartphone app diaries record drinking behavior for self-monitoring. A smartphone app can be expected to also be helpful for physicians because it can provide rich patient information to hepatologists, leading to suitable feedback. We conducted this prospective pilot study to assess the use of a smartphone app as a journaling tool and as a self-report–based feedback source for patients with ALD.
ObjectiveThe aims of this study were assessment of whether journaling (self-report) and self-report–based feedback can help patients maintain abstinence and improve liver function data.
MethodsThis pilot study used a newly developed smartphone journaling app for patients, with input data that physicians can review. After patients with ALD were screened for harmful alcohol use, some were invited to use the smartphone journaling app for 8 weeks. Their self-reported alcohol intake, symptoms, and laboratory data were recorded at entry, week 4, and week 8. Biomarkers for alcohol use included gamma glutamyl transferase (GGT), percentage of carbohydrate-deficient transferrin to transferrin (%CDT), and GGT-CDT (GGT-CDT= 0.8 × ln[GGT] + 1.3 × ln[%CDT]). At each visit, their recorded data were reviewed by a hepatologist to evaluate changes in alcohol consumption and laboratory data. The relation between those outcomes and app usage was also investigated.
ResultsOf 14 patients agreeing to participate, 10 completed an 8-week follow-up, with diary input rates between 44% and 100% of the expected days. Of the 14 patients, 2 withdrew from clinical follow-up, and 2 additional patients never used the smartphone journaling app. Using the physician’s view, a treating hepatologist gave feedback via comments to patients at each visit. Mean self-reported alcohol consumption dropped from baseline (100, SD 70 g) to week 4 (13, SD 25 g; P=.002) and remained lower at week 8 (13, SD 23 g; P=.007). During the study, 5 patients reported complete abstinence. No significant changes were found in mean GGT and mean %CDT alone, but the mean GGT-CDT combination dropped significantly from entry (5.2, SD 1.2) to the week 4 visit (4.8, SD 1.1; P=.02) and at week 8 (4.8, SD 1.0; P=.01). During the study period, decreases in mean total bilirubin (3.0, SD 2.4 mg/dL to 2.4, SD 1.9 mg/dL; P=.01) and increases in mean serum albumin (3.0, SD 0.9 g/dL to 3.3, SD 0.8 g/dL; P=.009) were recorded.
ConclusionsThese pilot study findings revealed that a short-term intervention with a smartphone journaling app used by both patients and treatment-administering hepatologists was associated with reduced drinking and improved liver function.
Trial RegistrationUMIN CTR UMIN000045285; http://tinyurl.com/yvvk38tj |
| first_indexed | 2024-03-08T22:01:10Z |
| format | Article |
| id | doaj.art-77a674e5839d407a8a767046b10e8e16 |
| institution | Directory Open Access Journal |
| issn | 2561-326X |
| language | English |
| last_indexed | 2024-03-08T22:01:10Z |
| publishDate | 2023-12-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR Formative Research |
| spelling | doaj.art-77a674e5839d407a8a767046b10e8e162023-12-19T13:45:36ZengJMIR PublicationsJMIR Formative Research2561-326X2023-12-017e4476210.2196/44762Narrowing the Patient–Physician Gap Based on Self-Reporting and Monthly Hepatologist Feedback for Patients With Alcohol-Related Liver Disease: Interventional Pilot Study Using a Journaling Smartphone AppNoriyo Yamashikihttps://orcid.org/0000-0002-9274-0000Kyoko Kawabatahttps://orcid.org/0000-0002-0950-717XMiki Muratahttps://orcid.org/0009-0004-2385-4196Shunichiro Ikedahttps://orcid.org/0009-0005-8593-3129Takako Fujimakihttps://orcid.org/0000-0003-2182-9152Kanehiko Suwahttps://orcid.org/0000-0003-1986-7061Toshihito Sekihttps://orcid.org/0009-0003-6529-9998Eiji Aramakihttps://orcid.org/0000-0003-0201-3609Makoto Naganumahttps://orcid.org/0000-0002-4244-3243 BackgroundScreening and intervention for alcohol use disorders (AUDs) are recommended to improve the prognosis of patients with alcohol-related liver disease (ALD). Most patients’ smartphone app diaries record drinking behavior for self-monitoring. A smartphone app can be expected to also be helpful for physicians because it can provide rich patient information to hepatologists, leading to suitable feedback. We conducted this prospective pilot study to assess the use of a smartphone app as a journaling tool and as a self-report–based feedback source for patients with ALD. ObjectiveThe aims of this study were assessment of whether journaling (self-report) and self-report–based feedback can help patients maintain abstinence and improve liver function data. MethodsThis pilot study used a newly developed smartphone journaling app for patients, with input data that physicians can review. After patients with ALD were screened for harmful alcohol use, some were invited to use the smartphone journaling app for 8 weeks. Their self-reported alcohol intake, symptoms, and laboratory data were recorded at entry, week 4, and week 8. Biomarkers for alcohol use included gamma glutamyl transferase (GGT), percentage of carbohydrate-deficient transferrin to transferrin (%CDT), and GGT-CDT (GGT-CDT= 0.8 × ln[GGT] + 1.3 × ln[%CDT]). At each visit, their recorded data were reviewed by a hepatologist to evaluate changes in alcohol consumption and laboratory data. The relation between those outcomes and app usage was also investigated. ResultsOf 14 patients agreeing to participate, 10 completed an 8-week follow-up, with diary input rates between 44% and 100% of the expected days. Of the 14 patients, 2 withdrew from clinical follow-up, and 2 additional patients never used the smartphone journaling app. Using the physician’s view, a treating hepatologist gave feedback via comments to patients at each visit. Mean self-reported alcohol consumption dropped from baseline (100, SD 70 g) to week 4 (13, SD 25 g; P=.002) and remained lower at week 8 (13, SD 23 g; P=.007). During the study, 5 patients reported complete abstinence. No significant changes were found in mean GGT and mean %CDT alone, but the mean GGT-CDT combination dropped significantly from entry (5.2, SD 1.2) to the week 4 visit (4.8, SD 1.1; P=.02) and at week 8 (4.8, SD 1.0; P=.01). During the study period, decreases in mean total bilirubin (3.0, SD 2.4 mg/dL to 2.4, SD 1.9 mg/dL; P=.01) and increases in mean serum albumin (3.0, SD 0.9 g/dL to 3.3, SD 0.8 g/dL; P=.009) were recorded. ConclusionsThese pilot study findings revealed that a short-term intervention with a smartphone journaling app used by both patients and treatment-administering hepatologists was associated with reduced drinking and improved liver function. Trial RegistrationUMIN CTR UMIN000045285; http://tinyurl.com/yvvk38tjhttps://formative.jmir.org/2023/1/e44762 |
| spellingShingle | Noriyo Yamashiki Kyoko Kawabata Miki Murata Shunichiro Ikeda Takako Fujimaki Kanehiko Suwa Toshihito Seki Eiji Aramaki Makoto Naganuma Narrowing the Patient–Physician Gap Based on Self-Reporting and Monthly Hepatologist Feedback for Patients With Alcohol-Related Liver Disease: Interventional Pilot Study Using a Journaling Smartphone App JMIR Formative Research |
| title | Narrowing the Patient–Physician Gap Based on Self-Reporting and Monthly Hepatologist Feedback for Patients With Alcohol-Related Liver Disease: Interventional Pilot Study Using a Journaling Smartphone App |
| title_full | Narrowing the Patient–Physician Gap Based on Self-Reporting and Monthly Hepatologist Feedback for Patients With Alcohol-Related Liver Disease: Interventional Pilot Study Using a Journaling Smartphone App |
| title_fullStr | Narrowing the Patient–Physician Gap Based on Self-Reporting and Monthly Hepatologist Feedback for Patients With Alcohol-Related Liver Disease: Interventional Pilot Study Using a Journaling Smartphone App |
| title_full_unstemmed | Narrowing the Patient–Physician Gap Based on Self-Reporting and Monthly Hepatologist Feedback for Patients With Alcohol-Related Liver Disease: Interventional Pilot Study Using a Journaling Smartphone App |
| title_short | Narrowing the Patient–Physician Gap Based on Self-Reporting and Monthly Hepatologist Feedback for Patients With Alcohol-Related Liver Disease: Interventional Pilot Study Using a Journaling Smartphone App |
| title_sort | narrowing the patient physician gap based on self reporting and monthly hepatologist feedback for patients with alcohol related liver disease interventional pilot study using a journaling smartphone app |
| url | https://formative.jmir.org/2023/1/e44762 |
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