Studies using mobile health applications are hampered by significantly high participant dropout rates, although retention strategies can help maintain participant engagement, according to a study published in JMIR.

The adoption of mobile health (mHealth) apps has been increasing in the research sphere, and researchers have been able to monitor day-to-day fluctuations of a wide range of real-time data using these apps.

However, a fundamental challenge to many studies is the rapid and substantial participant dropout, the study explained.

The researchers focused on databases of mHealth studies in PubMed, MEDLINE and PsycINFO databases for mHealth studies from 2015 to 2020. In one large-scale mHealth study included in the report, the Stanford-led MyHeart Counts study, the engagement with the app was only 4.1 days.

"It is imperative for mHealth studies to minimize participant dropout, as substantial attrition may reduce study power and threaten the representativeness of the sample," the report advised.

The addition of reminders, such as push notifications and SMS text messages, and the enabling of communication with clinicians are expected to increase participant retention.

The study also found that mHealth apps with lower barriers to entry, such as making the app free to download, did not guarantee a high degree of adherence, as the barrier to exit was also correspondingly low. 

"Research involving apps without gamification, notifications of some sort, or support from peers or coaches was more likely to mention these as potential rationales for poor engagement and areas that could be improved in the future," the study added.

WHY IT MATTERS

The market for mobile health apps is expected to grow at a compound annual growth rate of 17.6% from 2021 to 2028. As remote monitoring solutions and remote care options continue to mature, mobile health apps will play an ever-larger role in healthcare.

The study indicated that retention rates for mobile health applications must be improved to effectively assess the value of the apps. This could be achieved by incorporating badges, competitions and rankings.

"It is imperative for mHealth studies to minimize participant dropout, as substantial attrition may reduce study power and threaten the representativeness of the sample," the report noted.

THE LARGER TREND

Mobile healthcare apps continue to proliferate at an astonishing rate, offering consumers everything from a daily ketone score to digital mental health mobile games.

Cardiac-focused startup Eko recently updated its app to include a heart-disease-detecting AI algorithm, which received FDA 510(k) clearance for finding atrial fibrillation and heart murmurs in 2020.

A development study published in JMIR earlier this month took a look at the App Rating Inventory. Built by the Defense Health Agency’s Connected Health branch, it scores apps in three categories: evidence, content and customizability. The system aims to help clinicians find high-quality tools to use with patients.

The study’s authors argue there aren't enough guidelines to help providers determine which apps are useful for their patients. The authors warned that the time it takes to vet apps has the potential to deter clinicians from integrating mobile apps into clinical practice and patient care.