Background: Chronic pain is one of the most common diseases in the world and requires a multidisciplinary treatment approach. Spinal cord stimulation is a possible treatment option, but these patients require close follow-up, which is not always feasible. Introduction: eHealth apps also offer the possibility of closer patient follow-up, although adherence tends to decrease over time, dropping to around 60%. To improve adherence to remote follow-up, we developed a remote follow-up system consisting of a mobile phone app for patients, a website for professionals and a remote support center.
Objective: To evaluate adherence to remote follow-up using a system with mobile phone app and a remote support center.
Methods: After review of the literature and approval by a multidisciplinary committee, a team of experts designed a follow-up system based on a mobile phone app, a website for professionals, and a remote support center. The system was developed with the collaboration of healthcare professionals and uses validated scales to capture patients' clinical data at each stage of treatment (pre-treatment phase, trial phase and implantation phase). Data was collected prospectively from January 2020 to August 2023, including total surveys sent and surveys answered, in addition to notifications sent.
Results: A total of 64 patients were included (40 female, 62.5%). At the end of the study, 19 patients were in the pre-treatment phase (29'7%), 8 had reached the trial phase (12.5%) and 37 reached the implantation phase (57.8%). The follow-up period was 15.30 ± 9.43 months (mean ± SD). A total of 1574 surveys were sent out, along with 488 SMS reminders and 53 reminder calls. The adherence rate decreased from 94.53% in the pre-treatment phase to 65.68% in the implantation phase, with an overall adherence rate for the app of 87.37%. ANOVA analysis showed that adherence was higher in the earlier phases of treatment (p < 0.001).
Conclusions: Our remote follow-up system, supported by a remote support center, improves adherence to follow-up, although adherence tends to decrease over time. Further studies are needed to investigate the correlation between adherence to the app and pain management.
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