Improving Patient Experience in ADPKD Treatment through a Urination-Tracking App

Industry: Healthcare, Research, Pharmaceuticals
Focus: Autosomal Dominant Polycystic Kidney Disease (ADPKD) and Tolvaptan (Jynarque®) Treatment
Technology: Mobile Application for Symptom Tracking

Problem Statement

Patients diagnosed with Autosomal Dominant Polycystic Kidney Disease (ADPKD) who take tolvaptan (Jynarque®) often experience frequent urination and urgency as a side effect of the medication. Monitoring and managing these symptoms are essential to improving patient comfort and treatment outcomes. However, existing methods for tracking urination frequency are cumbersome, leading to underreporting or incomplete data collection.

One of our clients needed a solution that would allow patients to easily and consistently track their urination patterns. It can help both patients and healthcare providers monitor symptoms more effectively. To this end, a mobile app was developed, allowing patients to record urination frequency and urgency during their tolvaptan treatment. The app needed to be intuitive, easy to use, and capable of capturing accurate, real-time data on patients’ daily urination patterns.

Solution

To address these challenges, a study was initiated with two key objectives:

1. Test the App’s Usability: A smartphone app was developed to help patients record their daily urination habits while on tolvaptan. The app guided participants to:
   • Set reporting times for daily entries (morning, throughout the day, and bedtime).
   • Log each urination event and associated details (e.g., urgency) in real-time.
2. Gather User Feedback: Following the week-long app usage, participants were interviewed to share their experiences, provide feedback on the app’s usability, and suggest improvements. This feedback would help ensure the app was intuitive and effective for future clinical trials.

Challenges

• Patient Compliance: Ensuring that patients consistently use the app for seven consecutive days to accurately report every urination event.
• Ease of Use: The app had to be simple enough to ensure that patients of all technological literacy levels could easily navigate and record data.
• Accurate Data Collection: The app needed to ensure that urination events were recorded in real-time and that daily summaries were comprehensive.

Implementation

1. App Development and Features:
   • Initial Setup: Users set an initial reporting time (coinciding with their first dose of tolvaptan) and an end-of-day reporting time. Push notifications reminded users to log their overnight and daily urination events.
   • Real-Time Reporting: Each time the user urinated, they logged the event in the app, ensuring precise tracking.
   • Daily Summary: At the end of each day, a reminder prompted users to summarize their urination habits and any changes they noticed.
2. Participant Experience:
   • Daily Entries: Over the course of 7 days, participants made entries about their urination frequency, urgency, and any notable symptoms.
   • User Interviews: At the end of the trial, participants engaged in one-on-one interviews with researchers from QualityMetric to provide feedback on their experience, including both positive and negative aspects of using the app.

Results

• Increased Data Accuracy: The app’s push notifications and real-time tracking resulted in more complete and accurate data on urination events compared to traditional self-reporting methods.
• Positive Patient Feedback: Users found the app easy to use, citing that the push notifications helped them remember to log their entries. The intuitive design allowed for efficient tracking with minimal disruption to daily routines.
• Better Understanding of Side Effects: The detailed and consistent data provided by the app allowed for a clearer understanding of how patients experienced the side effects of tolvaptan, which could help in optimizing treatment plans.
• Actionable Feedback for App Improvements: The feedback from interviews provided valuable insights into minor areas of improvement, such as simplifying navigation between screens or adjusting notification frequency. These improvements were noted for future app updates before the platform is used in broader clinical trials.

Conclusion

The urination-tracking app developed by Logzero Technologies for Otsuka Pharmaceutical in collaboration with QualityMetric and Global Perspectives proved to be a successful tool for collecting real-time data on patients undergoing tolvaptan treatment for ADPKD. The app’s user-friendly interface and timely notifications led to improved data collection and patient engagement. Feedback from participants was instrumental in refining the app to ensure its efficacy in future clinical trials. Its ultimate goal is to enhance patient care and monitoring in ADPKD treatment.

This study marks an important step toward integrating digital tools into clinical research. It ensures that both patient experiences and treatment outcomes are accurately monitored and addressed.

Technology for Admin Panel

1. Programming Language: PHP
   • PHP (Hypertext Preprocessor) is a widely used open-source scripting language especially suited for web development. It’s a server-side language, which runs on the server and sends the output (HTML, JSON, XML, etc.) to the user’s browser. PHP is known for its simplicity, flexibility, and strong integration with databases, making it a popular choice for dynamic web applications.
   • React.js is a JavaScript library used for building user interfaces, specifically single-page applications (SPAs). It handles the front-end part of the application and focuses on creating fast, dynamic, and interactive user interfaces. With React, developers can build components that render data from the backend in real time, ensuring a seamless and responsive user experience. React’s virtual DOM improves performance by updating only the parts of the page that need changes, rather than reloading the entire page.

Combining PHP with React.js offers a powerful and modern web stack where PHP manages backend processes while React handles dynamic front-end rendering.

1. Framework: Laravel
   • Laravel is a PHP-based web framework that simplifies complex tasks involved in developing web applications. It follows the MVC (Model-View-Controller) architectural pattern, which separates the application logic (Model), user interface (View), and request handling (Controller). Laravel offers tools for database management, session handling, authentication, and routing. It accelerates the development process while ensuring scalability and maintainability. It’s favored for its clean syntax, rich ecosystem, and built-in security features.
2. Database: MySQL
   • MySQL is an open-source relational database management system (RDBMS) that stores and organizes data in tables, making it easy to manage, query, and manipulate data. It’s widely used due to its speed, reliability, and flexibility. In this setup, MySQL serves as the backend database where information about users, vendors, orders, and products is stored. And also, other data is stored and retrieved by the application.

Technology for Mobile App (Patient’s App)

1. Type: Hybrid
   • A Hybrid app combines elements of both native and web applications. Hybrid apps are built using web technologies like HTML, CSS, and JavaScript. But it runs inside a native container, allowing them to be deployed across multiple platforms (iOS, Android) from a single codebase. Hybrid apps offer a cost-effective solution since developers only need to maintain one codebase rather than separate codebases for each platform.
2. Programming Language: Flutter
   • Flutter is an open-source UI toolkit developed by Google for building natively compiled applications for mobile (iOS and Android), web, and desktop from a single codebase. Flutter uses the Dart programming language, and it provides a rich set of pre-designed widgets and tools that help in developing fast, beautiful, and responsive user interfaces. With Flutter, developers can create high-performance hybrid apps that feel and behave like native apps across both iOS and Android platforms. It reduce development time and effort while maintaining a consistent user experience.

Summary

• PHP and Laravel: These are used for the backend and front end of the web panels, offering a secure, scalable, and well-structured solution for managing the website, admin panel, and vendor panel.
• React.js: Manages the front end, providing dynamic and interactive user interfaces for panels and websites.
• MySQL serves as the database for storing application data in a relational format.
• Flutter:  It is employed for building hybrid mobile apps, enabling the development of a single app that works across both Android and iOS platforms, ensuring cost efficiency and consistency in the user experience.