One-year experiences with a personalised eHealth app to guide patients with an abdominal aortic aneurysm and their informal caregivers through perioperative care.

UNLABELLED: 1 BACKGROUND: Electronic health (eHealth) interventions may reduce the clinical demand of abdominal aortic aneurysm (AAA) care. However, how older AAA-patients use apps during long-term follow-up remains under explored. This study evaluated a personalised perioperative smartphone application (app) for AAA-patients and caregivers. METHODS: Long-term app use was prospectively assessed in patients undergoing AAA-repair and their informal caregivers. The app provided personalised perioperative information (lifestyle advice on physical exercise, nutrition, and reducing smoking and alcohol intake), and automatically collected user-engagement metrics, patient-reported outcome measures (PROMs), caregiver outcome measures (COMs), patient-satisfaction questionnaires, and lifestyle behaviour questionnaires. Use was assessed by app-retention, user-engagement, and questionnaire response rates. RESULTS: App-retention was 90% at 12 months in 118 patients (mean age 74 years) and 82 caregivers. User-engagement was significantly higher up to 2 months postoperatively than thereafter (p<0.001). App-based PROMs response rates were lower only at 12 months than a paper-based control cohort of 152 AAA-patients and 99 caregivers (59% versus 94%, p=0.018), while COMs response rates did not differ significantly. Median patient-satisfaction was ≥7 at all timepoints for guidance, information, usefulness, and recommendation, except usefulness at 6 and 12 months. Among smokers and alcohol users (≥7 units/week), 50% smoked less and 38% drank less at 12 months. CONCLUSIONS: The personalised eHealth app demonstrated high long-term retention and user-engagement in older AAA-patients, was positively valued, and may positively influence lifestyle behaviour. Administering app-based PROMs and COMs was feasible, but yielded lower response rates at 12 months. Supplementing app-based PROMs with paper-based PROMs may improve response rates.