Acceptance Factors of Mobile Apps for Diabetes by Patients Aged 50 or Older: A Qualitative Study

Abstract

BackgroundMobile apps for people with diabetes offer great potential to support therapy management, increase therapy adherence, and reduce the probability of the occurrence of accompanying and secondary diseases. However, they are rarely used by elderly patients due to a lack of acceptance.ObjectiveWe investigated the question “Which factors influence the acceptance of diabetes apps among patients aged 50 or older?” Particular emphasis was placed on the current use of mobile devices/apps, acceptance-promoting/-inhibiting factors, features of a helpful diabetes app, and contact persons for technical questions. This qualitative study was the third of three substudies investigating factors influencing acceptance of diabetes apps among patients aged 50 or older.MethodsGuided interviews were chosen in order to get a comprehensive insight into the subjective perspective of elderly diabetes patients. At the end of each interview, the patients tested two existing diabetes apps to reveal obstacles in (first) use.ResultsAltogether, 32 patients with diabetes were interviewed. The mean age was 68.8 years (SD 8.2). Of 32 participants, 15 (47%) knew apps, however only 2 (6%) had already used a diabetes app within their therapy. The reasons reported for being against the use of apps were a lack of additional benefits (4/8, 50%) compared to current therapy management, a lack of interoperability with other devices/apps (1/8, 12%), and no joy of use (1/8, 12%). The app test revealed the following main difficulties in use: nonintuitive understanding of the functionality of the apps (26/29, 90%), nonintuitive understanding of the menu navigation/labeling (19/29, 66%), font sizes and representations that were too small (14/29, 48%), and difficulties in recognizing and pressing touch-sensitive areas (14/29, 48%). Furthermore, the patients felt the apps lacked individually important functions (11/29, 38%), or felt the functions that were offered were unnecessary for their own therapy needs (10/29, 34%). The most important contents of a helpful diabetes app were reported as the ability to add remarks to measured values (9/28, 32%), the definition of thresholds for blood glucose values and highlighting deviating values (7/28, 25%), and a reminder feature for measurement/medication (7/28, 25%). The most important contact persons for technical questions were family members (19/31, 61%).ConclusionsA lack of additional benefits and ease of use emerged as the key factors for the acceptance of diabetes apps among patients aged 50 or older. Furthermore, it has been shown that the needs of the investigated target group are highly heterogeneous due to varying previous knowledge, age, type of diabetes, and therapy. Therefore, a helpful diabetes app should be individually adaptable. Personal contact persons, especially during the initial phase of use, are of utmost importance to reduce the fear of data loss or erroneous data input, and to raise acceptance among this target group.

Factors Influencing the Use of a Mobile App for Reporting Adverse Drug Reactions and Receiving Safety Information: A Qualitative Study

“…For effective risk communication, trust and/or confidence in the source/receiver are important [30]. Our results are similar to previous studies about app use with respect to influencing factors such as ease of use, language, layout, and costs [24, 31]. These can be seen as general influencing factors for using any app.…”

“…This will improve acceptance of the app [22]. Previous studies have been conducted to identify factors that may influence the use of mobile apps on, for instance, managing obesity [23] and diabetes mellitus [24] or preventing sexually transmitted infections and drug abuse in adolescents [25]. These studies show that app use will be influenced by factors such as ease of use, layout, and security of the data held in the app.…”

Barriers for User Acceptance of Mobile Health Applications for Diabetic Patients: Applying the UTAUT Model

“…For patients aged 50 years or older, effort expectancy was identified as a key factor for diabetes applications [24]. The positive impact of effort expectancy on behavioural intention is supported by other studies that analysed consumer usage of health informatics [25].…”

“…Health apps are downloaded and used without guidance [34]. Therefore, to raise the level of acceptance among older users, allow for personal contact persons during the initial phase of use [24] and training.…”

Clinical relevance of smartphone apps for diabetes management: A global overview

“…Although studies have demonstrated the ability of technology to improve access to care, inequality is still high between younger and older and more and less deprived populations . We need apps with elderly friendly features, as the elderly population is capable of adopting mHealth. While e‐commerce and m‐commerce have grown tremendously in China, mHealth presents more challenges in terms of pricing and regulations …”