Mobile apps offer options for tracking HIV management

There are mobile apps for nearly every kind of medical need, including HIV management. Between apps to find testing centers, check medications and even dating apps to find other HIV-positive partners, providers might have a difficult time navigating which apps might be best to recommend to their patients, however Although there has been little evidence-based research on the use of apps in HIV management, Kathryn Muessig, PhD, of the University of North Caroline at Chapel Hill said she anticipates significant advances over the next few years. Well-designed, evidence-based apps can help patients with self-management, including reminding them to fill and take medications, educating them about their disease, and motivating them to comply with their treatment plan. “Apps can also be used in the capacity of building a patient’s support network which might include new ways of linking them with their care provider team, peer-supporters, or other HIV-positive individuals,” Muessig said. “Peer support and social support are demonstrated to improve patient outcomes and for a disease like HIV that continues to face a fair amount of stigma and technology tools can help facilitate this where it otherwise may not have existed.” Next: Did apps pass the test? In the study, “Mobile Phone Applications for the Care and Prevention of HIV and Other Sexually Transmitted Diseases: A Review,” published in the Journal of Medical Internet Research, Muessig and a research team at UNC tested more than 50 HIV-related apps-some that provided information, others that were targeted at testing sites and resources and many promoting safe sex practices. Only 11% of the apps tested incorporated all of those elements, and many received just mediocre ratings from users. The research team at UNC, which is working on designing apps for use in HIV patients, also focused on design of HIV-related apps in their studies as ways to contribute to breaking down the negative associations of the disease, Muessig said. “For example, we incorporate gamification features into apps, upbeat themes and health and lifestyle information about more than just HIV. We keep patients at the center of and engaged in app design at all stages of development so that their perspectives, needs and preferences shape the tools we develop,” Muessig told Medical Economics “If medical records and an app can be synched in a HIPAA-compliant way, you could envision benefits to both patients and providers whereby certain actions by a patient, such as recording missed medication doses, might trigger action by a provider, including a prompt for a follow-up visit,” Muessig said. For compliant patients, apps could provide convenience. For those not in compliance with treatment recommendations, apps could provide a way to interact and connect with interventions on a daily basis when a physician is not available. Next: Do apps make a difference? App impact still undefined Muessig reiterated that it’s too soon to tell whether HIV-targeted apps are improving patient outcomes or compliance with treatment regimens, but there might be lessons that can be learned in other care areas-such as diabetes or weight management-where medical apps have been used and evaluated more extensively. “PCPs may need to be cautious in how they recommend apps to their patients. In most cases, these apps have not been tested rigorously in studies in such a way that would enable physicians to say with confidence that a patient could improve their health or some aspect of their care by using the app,” Muessig warned. Apps that boast at-home diagnosis are not reliable, but there is an expansion in the market for HIV at-home self-testing that may be worthy of attention. “I think some of the resistance toward self-testing is not around it usurping the role of the physician but rather that people who test positive will not follow-up with a physician to get linked to care,” Muessig said. “We view these technologies more as complementing physician care. For most people, HIV has really been transformed into a chronic condition. This means that the majority of care a patient needs to manage their condition is really driven by self-care. For example, a patient who is stable on treatment and doing well making their regular appointments-they might only see their doctor three or four times a year. The rest of the time they are on their own.” The following list is a sample of some popular apps for HIV management. • AIDS info • HIVPlus Treatment Guide • Poz Tracker • HIV Atlas • HIV Testing Sites and Care Services Locator • Liverpool HIV Chart