Patient Engagement With A Mobile App Specifically Designed For Use In Children With Long-Term Neurological Conditions

Introduction The NeuroRehab mobile app displays Education pages and features Seizure, Pain and Sleep Diaries. How apps best integrate into care delivery for neurology conditions is unknown.

Methods App engagement metrics were applied to anonymised user data (parents of Neurology patients), sampled over 24 months from July 2021.

Results Data on 3342 active interactions from 1005 user profiles were studied. Users doubled in Year 2 and user stickiness, which measures how often users return to an app, averaged 8.41% (+/-1.58 (SD), range 6.5-13.4%).

Returning users were highest for Seizure Diary (116 of 376 users, 30.9%) followed by Education pages (Personal Action Plan (58/233, 24.9%), Care tips (49/244, 20.1%) and Home Therapy instructions (73/382, 19.1%)) but overall retention time was greater for Education pages (median 31.5 (Interquartile range, IQR 1, 104.3) vs 9.5 (IQR 1, 82.75) days for all Diaries (p=0.041)).

The 7-Day and 30-Day rolling retention was 21.0% and 11.7%, respectively, for all users. Factors predicting a returning user were completion of clinical profiles at onboarding (Odd’s Ratio (OR) 4.02 (95%CI 2.95-5.46), p<0.0001) and use of ≥2 app features (OR 4.63 (3.25-6.53) Positive predictive value 80.2%, Likelihood ratio 3.37) but not with app use within 7-days of download (p<0.05). Diaries were more likely used if Education pages were also accessed (OR 3.28 (1.2.20-4.92) p<0.0001).

Conclusions The NeuroRehab app utilization resembles standard medical apps with a rapid decay in retention. Neurology apps should best target short-term goals and be education-focused, for example, on-boarding information for patients with a new neurological condition.