{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T09:08:27Z","timestamp":1785575307977,"version":"3.56.0"},"reference-count":32,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T00:00:00Z","timestamp":1771804800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T00:00:00Z","timestamp":1771804800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["PI23\/01065"],"award-info":[{"award-number":["PI23\/01065"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Viral Hepatitis"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Chronic hepatitis B (CHB) and hepatitis D (CHD) remain global health challenges, where sustained care engagement, treatment adherence and regular monitoring are essential but often limited by stigma and healthcare access. Digital health tools offer new opportunities to bridge these gaps. This study aimed to adapt the NORA mobile health app for CHB and CHD patients and evaluate its real\u2010world utility in improving knowledge, adherence, communication and quality of life. We conducted a prospective, comparative study (February 2022\u2013April 2024) including adult CHB (HBsAg\u2010positive, HBeAg\u2010negative) or CHD (anti\u2010HDV or HDV\u2010RNA\u2010positive) patients with mobile access and Spanish proficiency. The app offered educational content, medication reminders, quality\u2010of\u2010life questionnaires (CLDQ, FACIT\u2010F, EQ\u20105D\u20105L), a chat function and a knowledge test. Sociodemographic, clinical and usage data were analysed. Of 406 patients evaluated (356 CHB, 50 CHD), 277 CHB and 41 CHD patients were eligible. Participation was high (CHB: 88.4%; CHD: 90.2%), with active use in 48.1% and 70.3%, respectively. App users were more often male and Caucasian, and CHD users more frequently had detectable HDV\u2010RNA. Patients with inactive HBV infection were less likely to use the app over the medium term (OR\u2009=\u20090.462,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.003), and those who did use the app missed fewer clinic visits than nonusers (8.4% vs. 18.1%; OR\u2009=\u20090.41,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.016). Among users, 85 were on antiviral therapy, 67% used the medication reminder, and chat use was higher in CHD and in treated patients (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.004). High adherence (68% CHB, 84% CHD) and knowledge gains were observed, particularly in CHB with higher education. CHD patients showed worse baseline quality of life and greater declines over time. This first real\u2010world study of a tailored mobile health (mHealth) app for CHB and CHD showed improved patient knowledge, adherence, communication and quality\u2010of\u2010life monitoring, with greater engagement in patients with advanced disease.\n                  <\/jats:p>","DOI":"10.1111\/jvh.70160","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T11:58:27Z","timestamp":1772971107000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Enhancing Chronic Hepatitis B and D Management Through a Tailored Mobile Health Application: Real\u2010World Outcomes From the Adaptation of the\n                    <scp>NORA<\/scp>\n                    App"],"prefix":"10.1111","volume":"33","author":[{"given":"Judit","family":"Romero\u2010Vico","sequence":"first","affiliation":[{"name":"Liver Diseases Research Group Vall D'hebron Research Institute  Barcelona Spain"},{"name":"Faculty of Nursing and Health Sciences Universitat de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Feliu","sequence":"additional","affiliation":[{"name":"Liver Diseases Research Group Vall D'hebron Research Institute  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Vargas\u2010Accarino","sequence":"additional","affiliation":[{"name":"Liver Diseases Research Group Vall D'hebron Research Institute  Barcelona Spain"},{"name":"Biomedical Research Networking Centre for Hepatic and Digestive Diseases (CIBERehd)  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ester","family":"S\u00e1nchez\u2010Gavil\u00e1n","sequence":"additional","affiliation":[{"name":"Neurology Department Vall D'hebron University Hospital  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Rib\u00f3","sequence":"additional","affiliation":[{"name":"Neurology Department Vall D'hebron University Hospital  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana","family":"Palom","sequence":"additional","affiliation":[{"name":"Liver Diseases Research Group Vall D'hebron Research Institute  Barcelona Spain"},{"name":"Biomedical Research Networking Centre for Hepatic and Digestive Diseases (CIBERehd)  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2239-4939","authenticated-orcid":false,"given":"Juan Carlos","family":"Ruiz\u2010Cobo","sequence":"additional","affiliation":[{"name":"Biomedical Research Networking Centre for Hepatic and Digestive Diseases (CIBERehd)  Madrid Spain"},{"name":"Department of Medicine Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar","family":"Riveiro","sequence":"additional","affiliation":[{"name":"Liver Diseases Research Group Vall D'hebron Research Institute  Barcelona Spain"},{"name":"Biomedical Research Networking Centre for Hepatic and Digestive Diseases (CIBERehd)  Madrid Spain"},{"name":"Department of Medicine Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"},{"name":"Hepatology Department Vall D'hebron University Hospital  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N\u00faria","family":"Fabrellas","sequence":"additional","affiliation":[{"name":"Faculty of Nursing and Health Sciences Universitat de Barcelona  Barcelona Spain"},{"name":"Institute of Biomedical Investigation August Pi I Sunyer (IDIBAPS)  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Buti","sequence":"additional","affiliation":[{"name":"Liver Diseases Research Group Vall D'hebron Research Institute  Barcelona Spain"},{"name":"Biomedical Research Networking Centre for Hepatic and Digestive Diseases (CIBERehd)  Madrid Spain"},{"name":"Department of Medicine Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"},{"name":"Hepatology Department Vall D'hebron University Hospital  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,23]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"Guidelines for the Prevention, Care and Treatment of Persons With Chronic Hepatitis B Virus Infection","year":"2015"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.2147\/PROM.S226936"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2007.11.011"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2017.03.021"},{"key":"e_1_2_10_6_1","volume-title":"ECDC. 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