The obesity epidemic in our country and across the world has significantly increased the numbers of patients suffering from Type II diabetes, hypertension, hyperlipidemia, heart disease, and some types of cancer. On an increasing frequency, I find myself addressing weight during clinic visits and occasionally struggling with how to help these patients. In a 20 minute appointment with numerous other chronic conditions to address, obesity is occasionally given short shrift. Furthermore, some patients are seemingly averse to discussing the issue similar to trying to get patients to exercise more and stop smoking.

Over the years, much research has gone into patient activation, shared decision making and motivational interviewing as forms of brief interventions that can be provided at the point of care. For example, every provider in my hospital recently completed training on a motivational interviewing technique called SBIRT to assist patients to cut down on alcohol use. That group has released an excellent companion app that is available for free.

One of the latest entries to the concept of patient activation is the app, PEP Tools. The app incorporates the concepts of patient activation and shared decision making. The basic premise is through learning and discussing their medical condition with a provider, the patient is now informed and activated and can make a shared therapy decision and take action on their own. The app’s companion website includes additional material for both patients and providers. However, the website/app currently only includes materials for shared decision making for weight management and gout.

The basic concept of the app is to select a patient with one of these two conditions, then use the PEPtools app to introduce the topic and review therapeutic options with the patient. Next, the app prompts you to send the patient a PEPtalk on the topic and discuss this material at the next visit and create a shared plan that the now informed and activated patient implements. The information sent to the patient is a link to a brief video divided into three modules (using the weight management example):

  1. Weight and your health.
  2. Weight loss medications.
  3. Tips for successful weight loss.

Login to iMedicalApps in order to view the following video review of PEPtools. Registration for iMedicalApps is free.

Evidence based medicine

There is quite a bit of evidence to support shared decision making, motivational interviewing and patient activation if you search the medical literature. However, neither the mobile app nor the companion website contains any references or supportive evidence.

What providers would benefit from this App?

Students, residents, mid-levels, nurses, staff physicians, any provider who may have to interact with a patient with a chronic condition such as obesity and potentially provide guidance on how to manage such condition.

    • Attempts to address chronic conditions from a unique angle.
    • Simple interface with high quality PEPtalks on weight management and gout.
    • Companion website helps to supplement material lacking from app.
  • Dislikes

     

    • No evidence or references to support material in the app.
    • Patient materials only available on the website or via emails to patient. Why not on the app itself?
    • Only two PEPtalks currently available which greatly limits app’s ability to be generalized.
    • Big Pharma sponsorship of modules is concerning for bias and conflicts of interest.
    • Not available for Android.
  • Overall

    A unique app with an underutilized approach to help providers manage chronic conditions such as obesity and gout. The modules on weight management and gout are well made, but the app is limited in its utility by not including those patient materials in the app, as well as the lack of other patient modules. Has potential to be robust if modules on diabetes, heart failure, hypertension, etc. were included/developed.

  • Overall Score
  • User Interface

    Design is pretty basic and patient materials only available on companion website or via emails to patients.

  • Multimedia Usage

    High quality patient modules on weight management and gout, but little other information on the app. Includes ability to email modules to patients from the app and provider materials to share at the point of care.

  • Price

    App is free, though modules are funded by the pharmaceutical industry.

  • Real World Applicability

    A simple app that utilizes patient activation to manage chronic conditions, but currently is too limited in its scope to recommend widely other than for its weight management module.

  • Device Used For Review

    iPhone 6 running iOS 8.4.1

  • Available for DownloadiPhoneiPad