Mobile Access to a Personal Therapy Management Platform Leads to Better Health Outcomes Among On-Demand Hemophilia Patients

BACKGROUND: A personal therapy management platform(PTMP) for hemophilia allows patients to electronically record treatments and offers physicians real-time access to patient reports. PTMP is available on web-based platforms(non-mobile) and PDA platforms(mobile). On-demand patients use factor-concentrate to initiate clotting during bleeding episodes while prophylaxis patients use it to proactively prevent bleeds. A statistical analysis of PTMP data received after April 2007 was performed to see if mobile access to PTMP leads to better clinical outcomes among patients using the two types of therapy.

METHODS: A total of 72 PTMP users from 4 sites in the UK were identified as 53 prophylaxis and 19 on-demand patients. Among prophylaxis patients were 37 non-mobile users and 16 PDA users. Among on-demand patients were 9 non-mobile users and 10 PDA users. Mobile and non-mobile users were compared using independent-sample t-tests on reporting measures such as bleeds from the PTMP database and outcome measures such as ER visits and hospitalizations from clinical charts.

RESULTS: Mobile on-demand patients reported more spontaneous bleeds than non-mobile on-demand patients, 36.1 to 10.9(p<0.009). Analysis of outcome variables revealed that mobile on-demand patients also had fewer ER visits, 1.4 to 3.4 on average, and 50% fewer hospitalizations leading to 2.8 fewer critical-care visits(p<0.04).

DISCUSSION: Mobile access to PTMP increases health outcomes among on-demand patients but has no impact among prophylaxis patients. As expected, PDA users are more likely to report bleeds than non-mobile users because mobile users have better access to the reporting tool, decreasing retroactive reporting and consequential inaccuracies.