Mobile Health Apps for the Control and Self-management of Type 2 Diabetes Mellitus: Qualitative Study on Users’ Acceptability and Acceptance

Abstract

Background Mobile health apps are promising tools to help patients with type 2 diabetes mellitus (T2DM) improve their health status and thereby achieve diabetes control and self-management. Although there is a wide array of mobile health apps for T2DM available at present, apps are not yet integrated into routine diabetes care. Acceptability and acceptance among patients with T2DM is a major challenge and prerequisite for the successful implementation of apps in diabetes care. Objective This study provides an in-depth understanding of the perceptions of patients with T2DM before use (acceptability) and after use (acceptance) regarding 4 different mobile health apps for diabetes control and self-management. Methods A descriptive qualitative research design was used in this study. Participants could choose 1 of the 4 selected apps for diabetes control and self-management (ie, Clear.bio in combination with FreeStyle Libre, mySugr, MiGuide, and Selfcare). The selection was based on a systematic analysis of the criteria for (functional) requirements regarding monitoring, data collection, provision of information, coaching, privacy, and security. To explore acceptability, 25 semistructured in-depth interviews were conducted with patients with T2DM before use. This was followed by 4 focus groups to discuss the acceptance after use. The study had a citizen science approach, that is, patients with T2DM collaborated with researchers as coresearchers. All coresearchers actively participated in the preparation of the study, data collection, and data analysis. Data were collected between April and September 2021. Thematic analysis was conducted using a deductive approach using AtlasTi9. Results In total, 25 coresearchers with T2DM participated in this study. Of them, 12 coresearchers tested Clear, 5 MiGuide, 4 mySugr, and 4 Selfcare. All coresearchers participated in semistructured interviews, and 18 of them attended focus groups. Personal health was the main driver of app use. Most coresearchers were convinced that a healthy lifestyle would improve blood glucose levels. Although most coresearchers did not expect that they need to put much effort into using the apps, the additional effort to familiarize themselves with the app use was experienced as quite high. None of the coresearchers had a health care professional who provided suggestions on using the apps. Reimbursement from insurance companies and the acceptance of apps for diabetes control and self-management by the health care system were mentioned as important facilitating conditions. Conclusions The research showed that mobile health apps provide support for diabetes control and self-management in patients with T2DM. Integrating app use in care as usual and guidelines for health care professionals are recommended. Future research is needed on how to increase the implementation of mobile health apps in current care pathways. In addition, health care professionals need to improve their digital skills, and lifelong learning is recommended.

Perceptions of COVID-19 and the Use of Health Information Technology Among People Who Are Uninsured: Multimethod Survey Study

“…Smartphone apps have been shown to be useful for understanding outbreak epidemiology, screening individuals, and conducting contact tracing, making them likely fixtures in future epidemics [63]. The functionality of mHealth apps as intervention tools has been tested across many countries globally, and the results show positive outcomes and high levels of support for these types of apps due to improved disease management and easy health information sharing [64][65][66][67]. With most uninsured respondents having access to a smartphone, there is high potential for using the COVID-19 app, especially when considering the rapid increase in health care technology during the pandemic [20].…”

Participation experience in self-care program for type 2 diabetes: A mixed-methods study

“…Previous studies have explored factors related to the participation in interventions utilizing apps for patients with type 2 diabetes mellitus (T2DM). Factors, such as health status, support from healthcare providers and relatives, awareness of app usage, and understanding of disease severity, technical literacy, and internet connectivity can influence participation in these interventions [11,12]. However, some studies only included participants with excellent disease management [11] or analyzed participants who had used an app as part of the intervention group [12].…”

“…Factors, such as health status, support from healthcare providers and relatives, awareness of app usage, and understanding of disease severity, technical literacy, and internet connectivity can influence participation in these interventions [11,12]. However, some studies only included participants with excellent disease management [11] or analyzed participants who had used an app as part of the intervention group [12]. In light of this, there is a lack of research comparing the experiences of individuals with low participation in utilizing apps with those with higher participation.…”

Digital Interventions for Self-Management of Type 2 Diabetes Mellitus: Systematic Literature Review and Meta-Analysis

“…This unmet need can be alleviated by a wider use of digital technologies designed to help patients with their lifestyle and health-related decisions through making accessible critical data and on-demand consultations [5]. The technologies for managing T2DM include medical devices such as glucose meters, insulin pumps, continuous glucose monitors, and connected insulin pens; digital interventions including mobile smartphone applications (apps), text messaging, electronic communications, and video conference platforms; and wearable technologies for monitoring health, such as activity trackers, sleep trackers, and smartwatches [6,7]. Digital health technologies can also support virtual healthcare services, outside of a clinic or office, by using remotely collected data and communication capabilities of mobile devices and the Internet [8].…”