Pttapp: An Application Developed By the Spanish Society of Hematology and Hemotherapy to Show Practical Recommendations on the Management of Immune TTP

Introduction. Immune thrombotic thrombocytopenic purpura (iTTP) is a rare and life-threatening disease. It is a true medical emergency with a mortality rate 2-8% in absence of adecuate treatment in the first hours after first symptoms and diagnosis. Due to the low incidence of the disease, 2-4 cases per million people/year, the individual experience of most physicians is generally limited. Moreover, the approach to diagnosis, treatment and follow up recommendations are not clearly established according to high-grade evidence. In addition, in the last years there have been numerous advances in the diagnosis and treatment of iTTP. The Spanish Group of Apheresis (GEA) with the support of The Spanish Society of Hematology and Hemotherapy (SEHH) has created an application with the objective to help doctors and other health professionals to optimize iTTP management.

Methods. The GEA selected a group of hematologist with recognize expertise in iTTP. This group elaborated a series of key questions with answers that included the current evidence of most of the doubts on iTTP among professionals who may face this pathology. The answers are based on the published recommendations and bibliography and they will be reviewed every six months. The selected group of hematologists was divided in two. The first group was in charge of the diagnosis; the second, of the treatment; and both, of iTTP follow-up. These groups held regular meetings with the app developers.

Results. The application is called PTTApp (PTTA is the acronym of iTTP in Spanish and Portuguese languages). It offers updated practical recommendations aimed at doctors and other health professionals in Spain, Portugal and South and Central America. The app is free and available for iOS and Android. The application menu comprises three large sections (diagnosis, treatment and follow-up), whose contents are presented in the form of 80 questions and answers. The answers include bibliographic references linked to the abstract of the corresponding publication in PubMed. The application also has a "Contact to the specialist” section, in which the user can send a written message to the "on duty” expert hematologist in iTTP from the SEHH and will receive response via email from Monday to Friday during working hours. Finally, PTTApp has a section with news of interest about the disease. The application has been built in a moldable design to implement information about other thrombotic microangiopathies (TMA) like typical or atypical hemolytic uremic syndrome (HUS), transplant or cancer related TMA. Besides, the possibility of translate into other languages is being considered to help colleagues from other countries.

Conclusions. The GEA, with the support of SEHH, has created PTTApp, an application with practical recommendations on the diagnosis, treatment and follow-up of patients with iTTP, in the form of questions and answers. This new consultation tool aims to help and accompany doctors and health professionals who treat patients with iTTP. In fact, users will be able to contact hematologists who are experts in the disease to resolve any doubts that may arise during their daily clinical practice.

Figure 1. Screenshots of the app: Home screen design, theme selection and contact with the reference specialist.

No relevant conflicts of interest to declare.