By A.J. Hostetler 
 
A smartphone app designed to help people with cirrhosis manage their health at home shows promise in reducing avoidable hospital visits, according to a new study led by Virginia Commonwealth University researchers. 

Cirrhosis, severe scarring of the liver, is a serious disease. Patients with the condition often go back to the hospital soon after they leave. In fact, almost 40% are readmitted within 30 days. Sometimes, these return trips could be avoided with better care at home, earlier clinic appointments and faster communication with doctors. 

Now, a new study shows that a free application for Android phones, called Patient Buddy, can help. The study, published in the medical journal Hepatology, showed that patients using the app were more likely to stay out of the hospital and manage their health better, especially in the critical 30 days after leaving the hospital.  

“The app made a real difference,” said Jasmohan Bajaj, M.D., a VCU Health liver specialist and researcher at the VCU Stravitz-Sanyal Institute for Liver Disease and Metabolic Health who led the study. “It helped patients catch problems sooner, kept their caregivers involved, educated them about their disease, and led to fewer avoidable trips back to the hospital.” 

Researchers from VCU worked with partners at the Mayo Clinic and Richmond VA Medical Center. They followed more than 200 patients across three types of hospitals: a veterans’ hospital, a safety-net hospital and a private hospital. Each patient had a caregiver – a family member or friend who helps the patient manage their health at home – who also participated in the study. 

Some patients used the Patient Buddy app, while others received regular care without the app. The researchers found that people using the app: 

• Had fewer trips back to the hospital within 30 days 
• Had fewer avoidable readmissions 
• Caught early warning signs of liver problems  
• Needed fewer trips to the intensive care unit  

The app helped patients track symptoms like memory problems, weight changes and bowel movements and whether important liver-related medications were taken on time. It also sent alerts to researchers and doctors if symptoms got worse. The most common alerts came from problems with thinking skills or bowel movements likely related to hepatic encephalopathy, a serious health problem from liver disease which often goes unnoticed by patients.  

Caregivers played a key role by learning how to use the app and talking with doctors when problems came up. Their help meant better medication tracking and faster care. 

The study found that older patients and those with a history of hepatic encephalopathy or bleeding had a higher risk of being readmitted. Those with a lower risk included those who used the app, were female or had a lower white blood cell count at discharge, which could indicate an infection. 

The Patient Buddy app didn’t prevent all hospital visits. Some patients also faced challenges, such as limited internet access or trouble using the technology. Still, the app helped lower avoidable hospital stays and worked well in many different hospital settings. 

Bajaj and his team have worked for years with Virginia-based Creative Information Technology, Inc., the company that developed the app, to make sure it fits the needs of patients with liver disease. 

“This is about making care safer and smarter for patients living with a serious illness, and keeping them and their families engaged and educated even when outside the hospital,” Bajaj said. “It’s about helping them stay home, and stay well, whenever possible and the app is our eyes and ears that helps us do this.” 

The next step for the team is to share information about the app’s capabilities to prevent avoidable readmissions in patients with cirrhosis and other chronic conditions.  

Other VCU researchers involved with the study include Jawaid Shaw, M.D., Andrew Fagan, BS, and Leroy Thacker, Ph.D. 

This study was funded by a grant from the U.S. Agency for Healthcare Research and Quality.

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