Effect of Smartphone Application-Enabled Daily Intervention for Patients with Nonalcoholic Steatohepatitis: A Feasibility Study

Background and Aims: The incidences of end-stage liver disease and hepatocellular carcinoma arising from nonalcoholic steatohepatitis (NASH) are rapidly increasing. Although weight reduction is recommended as an initial treatment, no pharmacologic treatments for this condition are presently available. The aims of the current study were(1) to develop a smartphone application-based intervention for weight reduction in NASH patients, and (2) to evaluate the feasibility of using this application in daily clinical practice. Methods: We developed a mobile phone application for NASH patients (NASH App). We then prospectively enrolled 9 clinically diagnosed NASH patients and applied a 24-week intervention using the NASH App in addition to the usual follow-up with laboratory and imaging studies. The use of the NASH App by the patients and the changes in weight and biomarkers were evaluated after the 24-week intervention. Results: The mean patient age was 37.67 years, and 7 patients (77.78%) were male. The mean BMI was 29.63 kg/m2. Seven patients completed the counseling provided by the NASH App. Since one patient was lost to follow-up, the comparison between pre- and post-intervention values was performed for 8 patients. A post-intervention weight reduction was observed in 7 patients, and this weight reduction was statistically significant (p=0.02).Normalization of the ALT level (<30 U/L) was observed in two patients. Conclusion: The NASH App intervention for NASH patients is feasible and acceptable. Further studies using a control arm and a larger population are needed to confirm the efficacy of the NASH App.