Development and effectiveness evaluation of a mobile health-based follow-up management model for patients after hematopoietic stem cell transplantation

TL;DR

A mobile health program improved quality of life and reduced complications in patients after stem cell transplants, compared to standard care.

Contribution

A novel mHealth follow-up model for HSCT patients was developed and shown to improve outcomes.

Findings

mHealth group showed significantly better quality of life and self-efficacy after 6 months.

Lower incidence of infections, CMV reactivation, and emotional disorders in the mHealth group.

Improved symptom management, patient satisfaction, and reduced readmissions with mHealth.

Abstract

To evaluate the association between mobile health (mHealth)–based follow-up and quality of life, self-management capacity, and complication control in patients after hematopoietic stem cell transplantation (HSCT).

This retrospective single-center cohort study included 310 HSCT recipients (January 2020–December 2024). Patients were assigned to an mHealth intervention group (n = 145) or standard-care group (n = 165). After 1:1 propensity score matching (caliper = 0.2), 248 balanced patients (124 per group) were analyzed. The control group received routine outpatient follow-up and standard education. In addition to routine care, the intervention group received 6-month mHealth-based management program incorporating real-time health monitoring with automated alerts, personalized education, medication management, and online professional support. Patients could upload health data in real time and consult medical staff online through the APP. Primary outcomes included quality of life, self-efficacy, and complication incidence; secondary outcomes included symptom management, satisfaction, laboratory parameters, and healthcare utilization. Multivariable regression and subgroup analyses were conducted to assess independent associations and consistency of findings.

At 6 months, the mHealth group showed significantly greater improvements in quality of life (EORTC +10.0 points, p < 0.001) and self-efficacy (+2.01 points, p < 0.001). The incidence of infection, cytomegalovirus (CMV) reactivation, and emotional disorders was lower in the intervention group (all p < 0.05). Among allogeneic recipients, mHealth management was associated with reduced graft-versus-host disease (GVHD) and CMV reactivation. Secondary outcomes were associated with better symptom management, higher patient satisfaction, favorable changes in immune and renal function indicators, and lower readmission rates and nursing visits (all p < 0.01). CD4 count and symptom management scores were independently associated with better quality of life and self-efficacy, whereas chronic comorbidities were associated with poorer outcomes. Higher BMI, CD4 level, and monitoring capacity were associated with a lower risk of complications. These observed associations remained consistent across subgroups. Engagement analysis indicated predominant use of monitoring functions; low participation (14.5%) was more common among older, less educated, and allogeneic transplant patients.

mHealth-based remote follow-up was associated with favorable changes in quality of life, self-efficacy, and complication rates after HSCT. While findings suggest potential clinical feasibility and scalability, causal inference is markedly limited by the retrospective design and inherent selection bias.

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