SPPACES: MEDICAL APP REVIEWS
Improving Daily Practice With Four Medical Apps
These mobile apps can help physicians and patients with treatment recommendations, treatment adherence, and smoking cessation.
Fam Pract Manag. 2017 Mar-Apr;24(2):27-29.
Author disclosure: no relevant financial affiliations disclosed.
It seems there's an application for everything these days, even in health care. More than 165,000 mobile health apps are now on the market, according to one report.1 Additionally, almost 60 percent of mobile phone users surveyed said they have downloaded a health-related mobile app.2
Finding quality apps to recommend to your patients or use yourself can be overwhelming. This article seeks to help, reviewing four highly useful medical apps using FPM's “SPPACES” app review criteria. (See “App review criteria.”) The apps can help primary care physicians with several common treatment tasks:
Determining whether to prescribe aspirin therapy,
Treating symptoms in menopausal women,
Ensuring patients adhere to their medication for acne,
Providing tobacco users motivation and reinforcement to quit.
APP REVIEW CRITERIA
S – Source or developer of app
P – Platforms available
P – Pertinence to primary care practice
A – Authoritativeness/accuracy/currency of information
C – Cost
E – Ease of use
S – Sponsor(s)
Aspirin Guide allows health care professionals to compare the risks and benefits of low-dose aspirin based on their patients' individual risk factors.
Source: Digital Clinix, LLC.
Pertinence to primary care practice: Aspirin Guide provides guidance for busy clinicians to determine if their patient is a candidate for low-dose aspirin therapy (75 mg to 81 mg daily). The app quickly calculates 10-year atherosclerotic cardiovascular disease (ASCVD) risk and bleeding risk scores as well as the number needed to harm (NNH) and the number needed to treat (NNT). It uses that information to provide an easily understood guidance statement advising for or against low-dose aspirin treatment.
Authoritativeness/accuracy/currency of information: Researchers at Harvard Medical School and Brigham and Women's Hospital developed the app. The aspirin bleeding risk is based on the 2016 U.S. Preventive Services Task Force's evidence synthesis and published studies cited on the app's website. The 10-year cardiovascular risk is based on the ASCVD calculator created by the American College of Cardiology and the American Heart Association (ACC/AHA).
Ease of use: The process takes a couple of minutes the first time you use the app. After continued use, entering data takes less than 30 seconds. Moreover, clinicians can email the summary to the patient, themselves, or both. The summary includes the patient's ASCVD risk score and recommendations for or against starting low-dose aspirin, as well as the NNT and NNH.
This is an essential app for anyone who counsels patients on starting or stopping low-dose aspirin.
MenoPro provides guidance on how to treat menopausal symptoms in women 40 years of age and older.
Source: Digital Clinix, LLC.
Pertinence to primary care practice: Determining appropriateness of hormonal treatment for climacteric symptoms is difficult. MenoPro provides guidance and resources for discerning whether a patient is a good candidate. The app has links to a breast cancer risk tool and an osteoporosis/bone fracture risk assessment tool. It also calculates a 10-year ASCVD risk score. The app provides great handouts on a variety of topics about hormonal and nonhormonal treatments, including lifestyle modifications and herbals, as well as U.S. Food & Drug Administration-approved treatments and off-label treatments. The information can be emailed to the patient, the physician, or both.
Authoritativeness/accuracy/currency of information: The 10-year ASCVD risk score is based on the ACC/AHA calculator. Treatment guidelines are based on the Women's Health Initiative Hormone Therapy Trials.
Ease of use: It is very simple to input patient data and gain recommendations within a minute.
Sponsor: North American Menopause Society.
This is a great resource for those who treat patients with menopausal symptoms.
Acne Spot Check
The Acne Spot Check app helps patients with acne adhere to their medication regimens and monitor the results.
Source: F5 Works Ltd.
Pertinence to primary care practice: One of the main contributors to poorly controlled acne is medication nonadherence. Sometimes this is because the patient does not know how treatment works or forgets to use the medication consistently. Acne Spot Check helps with both. Patients can use the app to set reminders to use their acne medication, see their primary care physician, and get refills of their medication.
Patients can also watch within the app a four-minute animated video about how their topical medication works and how it should be applied.
Authoritativeness/accuracy/currency of information: Although the app is targeted to patients who are using EpiDuo, the app reminders and user tips are useful for all acne patients. The treatment advice is accurate for anyone using both a topical retinoid, such as adapalene, and benzoyl peroxide, which are first-line treatments for most types of acne. No specific sources for the app's information are cited.
Ease of use: The app is very easy to use. Patients can take “selfies” to monitor how their acne treatment is progressing. They can quickly create reminders to help them achieve better adherence with their acne treatment.
This is an imperative app for acne patients.
The Smokerstop app enables patients to track how long they have been smoke-free and what they have gained in terms of health and wealth (e.g., savings from not purchasing cigarettes).
Source: Titus J. Brinker.
Pertinence to primary care practice: Many patients who are addicted to nicotine have a hard time staying motivated when they do decide to quit. To receive help with this, app users can choose to get notifications whenever they reach a new level of financial or health benefit, can create custom monetary incentives that they are working toward, and can view progress related to past and present achievements. The “Mentor” tab provides advantages and disadvantages of smoking, tips to help users stay smoke-free, and the amount of money saved hourly, monthly, and annually by stopping smoking. The most unique motivator in the app is a link to Smokerface, a photoaging app that shows users what they will look like in one to 15 years if they continue smoking.
Authoritativeness/accuracy/currency of information: This app was created using input from Brigham and Women's Hospital faculty as well as Harvard faculty including the New England Journal of Medicine's editor-in-chief.
Ease of use: Some of the initial data entry is difficult to discern, such as the amount of carbon monoxide, tar, and milligrams of nicotine. After the initial setup, however, the interface is intuitive.
Sponsors: Education Against Tobacco.
This is a great app for anyone who is ready to quit smoking and wants to stay motivated.
1. IMS Institute for Healthcare Informatics. Patient adoption of mHealth: use, evidence and remaining barriers to mainstream acceptance. Parsippany, NJ: IMS Institute for Healthcare Informatics; 2015. http://bit.ly/2iei239. Accessed Feb. 2, 2017.
2. Krebs P, Duncan DT. Health app use among U.S. mobile phone owners: a national survey. JMIR Mhealth Uhealth. 2015;3(4):e101.
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