Statistical analysis
NPS
The primary endpoint was feasibility of using the application in a clinical setting, with feasibility demonstrated if at least 40% of all enrolled participants engaged with the app at least three times during the 12-week study period. Engagement was defined as login and interaction with at least one app feature. Login to complete the baseline and follow-up survey was not included. Secondary endpoints included the average SUS and the NPS. The average SUS score in the literature is 68, and the study set 70 or above as a measure of usability [Descriptive statistics for survey responses including frequencies, proportions, medians, and means were computed. Exploratory analyses evaluated the association between participants’ sociodemographic and clinical characteristics and their level of engagement (≥ 5 versus < 5 interactions during study period) and overall satisfaction (≥ 7 versus < 7, corresponding to NPS “promoter” or “passive” versus “detractor”) with the app using Fisher’s exact test. Additional exploratory analyses assessed the association between participant characteristics and SUS using the Kruskal–Wallis test. A two-sided significance level of 0.05 was used, without adjustment for multiple comparison due to the exploratory nature of the analyses.