Patient-Centered Hidradenitis suppurativa Mobile Apps: Systematic Identification, Analysis and Assessment (Preprint)

BACKGROUND Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease characterized by inflammatory nodules, abscesses and fistulas in intertriginous sites such as the axilla, groin and anogenital areas. HS lesions cause persistent pain, weeping sores with malodour and disfiguring scarring. It is a major contributor to psychosomatic distress. Early diagnosis and timely, optimal treatment are essential to control the disease and improve patients' quality of life. The cumulative burden of recurrent flares, suboptimal therapies and prolonged misdiagnosis places a significant burden on both patients and healthcare systems. OBJECTIVE This study aimed to identify publicly available mobile health apps (MHAs) for HS patients and evaluate their quality through assessments by both patients and physicians. METHODS Two reviewers searched Apple App Store, Google Play Store and the internet for MHAs for HS. Two apps met the inclusion criteria. These apps were evaluated by 20 physicians and 27 patients using the Mobile App Rating Scale (MARS), uMARS, the German Mobile App Usability Questionnaire (G-MAUQ) and technology affinity tools (ATI and MDPQ-16). RESULTS This study identified two patient-centered apps for hidradenitis suppurativa (HS) that met the inclusion criteria - the HSR-Patients app and the EHSF-Hidradenitis Suppurativa app - from an initial pool of 29 proposed apps that included many non-medical, non-HS-specific, and non-patient-centered apps. Patients rated the quality of the HSR app significantly higher than physicians did, with a MARS score of 3.01 (SD 0.60) from physicians and a uMARS score of 3.53 (SD 0.69) from patients (p = 0.009). In contrast, the EHSF app showed no significant difference in quality ratings between doctors and patients, with MARS scores of 2.81 (SD 0.55) from physicians and 2.72 (SD 0.79) from patients (p = 0.688). Usability, assessed with the G-MAUQ, showed no significant difference between doctors and patients for either app. For the HSR app, physicians rated usability at 4.37 (SD 0.86) and patients at 4.72 (SD 1.21) (p = 0.265). For the EHSF app, physicians rated usability at 3.88 (SD 0.77) and patients at 3.38 (SD 1.35) (p = 0.114). Patients showed a significantly higher general affinity for technology than physicians, as measured by the ATI (physicians: 3.62 (SD 0.61); patients: 4.38 (SD 1.30); p = 0.011). However, there was no significant difference in affinity for technology specifically when using mobile devices, as assessed by the MDPQ-16 (physicians: 4.83 (SD 0.25); patients: 4.69 (SD 0.72); p = 0.410). CONCLUSIONS Patients and physicians evaluate MHAs differently. Patients focus on ease of use and practical guidance, whereas physicians emphasize content and usability. Neither app showed sufficient potential for long-term use, highlighting the need for participatory development involving all stakeholders.