Self-Care Oriented Smartphone Apps for Type 2 Diabetes: A Systematic Review (Preprint)

2021 ◽  
Author(s):  
Lucija Gosak ◽  
Nino Fijačko ◽  
Jeroen Ooge ◽  
Janja Kamenšek ◽  
Nika Debeljak ◽  
...  

BACKGROUND Type 2 Diabetes Mellitus (T2DM) is a common cause of mortality worldwide: each year, the chronic disease kills over one million people, making it the ninth leading cause of death. The growing use of smartphone applications (apps) led to focusing on mobile health, which is increasingly oriented towards self-care of T2DM. With smartphone apps, patients can improve their self-care behavior and prevent complications of the disease. OBJECTIVE This research aims to search, analyze, and evaluate the quality of existing smartphone apps for self-care of diabetic patients to improve disease control and health status. METHODS In the Google Play Store and iPadian emulator, we systematically searched for Android and iOS smartphone apps. Smartphone apps that met the inclusion criteria were analyzed and evaluated with the American Association of Diabetes Educators’ self-care tool and the user version of the Mobile App Rating Scale, which assesses the integration of self-care behavior functions, and overall quality, respectively. RESULTS Out of 798 smartphone apps, we identified 12 relevant smartphone apps that included 51 out of 88 predefined self-care behavior functions. The average score for overall quality was 3.76/5 (SD=0.31), and the smartphone apps WeCheck -Diabetes lifelog, Blood Glucose Level, Smart e-SMBG - Diabetes lifelog, and Blood Glucose contained the most self-care behavior functions. CONCLUSIONS We argue that T2DM monitoring can be improved by implementing the correct quantity of self-care behavior functions and including elements related to the prevention of complications due to the T2DM.

2021 ◽  
Vol 14 (1) ◽  
pp. 494-498
Author(s):  
Prapada Watcharanat ◽  
Kitsarawut Khuancheree ◽  
Brian Lee

Introduction: Diabetes belongs to the chronic disease group with an average high prevalence rate of 463 million worldwide. This research aims to investigate factors associated with self-care behavior among elderly patients with type 2 diabetes. Methods: The sample included 441 patients diagnosed with diabetes admitted to the Tambon Health Promoting Hospital in Nakhon Nayok Province. The sample size used in this study was calculated according to the sampling group of Yamane with a 95% confidence level. Data were analyzed by descriptive statistics, correlation coefficients, and multiple regression analysis at the statistical significance level of 0.05. Results: The results showed that the average value of knowledge was 9.17 (SD=2.38), and the average values of attitude and social support behavior towards diabetes were 2.72 (SD=0.64) and 1.83 (SD=0.27), respectively. The results indicated that knowledge, attitude, and social support towards diabetes showed an average of a medium level. Moreover, the average value of self-care behavior towards diabetes was 30.52 (SD= 7.19). The results indicated that the knowledge about diabetes, attitude towards diabetes, and social support towards diabetes positively affected self-care behavior towards diabetes with the statistical significance of 0.05. Conclusion: Health promotion programs for patients with diabetes should be organized to promote knowledge and awareness on proper health behavior. In order to take care of themselves, diabetic patients must first get awareness regarding diabetes and then build skills for self-care. The results obtained in the study can help diabetic patients stay healthier, reduce the manifestation of both acute and chronic complications, and improve the quality of life of the elderly with diabetes.


2019 ◽  
Author(s):  
Kaifeng Liu ◽  
Zhenzhen Xie ◽  
Calvin Kalun Or

BACKGROUND Mobile app-assisted self-care interventions are emerging promising tools to support self-care of patients with chronic diseases such as type 2 diabetes and hypertension. The effectiveness of such interventions requires further exploration for more supporting evidence. OBJECTIVE A systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted to examine the effectiveness of mobile app-assisted self-care interventions developed for type 2 diabetes and/or hypertension in improving patient outcomes. METHODS We followed the Cochrane Collaboration guidelines and searched MEDLINE, Cochrane Library, EMBASE, and CINAHL Plus for relevant studies published between January 2007 and January 2019. Primary outcomes included changes in hemoglobin A<sub>1c</sub> (HbA<sub>1c</sub>) levels, systolic blood pressure (SBP), and diastolic blood pressure (DBP). Changes in other clinical-, behavioral-, knowledge-, and psychosocial-related outcomes were included as secondary outcomes. Primary outcomes and objective secondary outcomes that were reported in at least two trials were meta-analyzed; otherwise, a narrative synthesis was used for data analysis. RESULTS A total of 27 trials were identified and analyzed. For primary outcomes, the use of mobile app-assisted self-care interventions was associated with significant reductions in HbA<sub>1c</sub> levels (standardized mean difference [SMD] −0.44, 95% CI −0.59 to −0.29; <i>P</i>&lt;.001), SBP (SMD −0.17, 95% CI −0.31 to −0.03, <i>P</i>=.02), and DBP (SMD −0.17, 95% CI −0.30 to −0.03, <i>P</i>=.02). Subgroup analyses for primary outcomes showed that several intervention features were supportive of self-management, including blood glucose, blood pressure, and medication monitoring, communication with health care providers, automated feedback, personalized goal setting, reminders, education materials, and data visualization. In addition, 8 objective secondary outcomes were meta-analyzed, which showed that the interventions had significant lowering effects on fasting blood glucose levels and waist circumference. A total of 42 secondary outcomes were narratively synthesized, and mixed results were found. CONCLUSIONS Mobile app-assisted self-care interventions can be effective tools for managing blood glucose and blood pressure, likely because their use facilitates remote management of health issues and data, provision of personalized self-care recommendations, patient–care provider communication, and decision making. More studies are required to further determine which combinations of intervention features are most effective in improving the control of the diseases. Moreover, evidence regarding the effects of these interventions on the behavioral, knowledge, and psychosocial outcomes of patients is still scarce, which warrants further examination.


10.2196/15779 ◽  
2020 ◽  
Vol 8 (8) ◽  
pp. e15779 ◽  
Author(s):  
Kaifeng Liu ◽  
Zhenzhen Xie ◽  
Calvin Kalun Or

Background Mobile app-assisted self-care interventions are emerging promising tools to support self-care of patients with chronic diseases such as type 2 diabetes and hypertension. The effectiveness of such interventions requires further exploration for more supporting evidence. Objective A systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted to examine the effectiveness of mobile app-assisted self-care interventions developed for type 2 diabetes and/or hypertension in improving patient outcomes. Methods We followed the Cochrane Collaboration guidelines and searched MEDLINE, Cochrane Library, EMBASE, and CINAHL Plus for relevant studies published between January 2007 and January 2019. Primary outcomes included changes in hemoglobin A1c (HbA1c) levels, systolic blood pressure (SBP), and diastolic blood pressure (DBP). Changes in other clinical-, behavioral-, knowledge-, and psychosocial-related outcomes were included as secondary outcomes. Primary outcomes and objective secondary outcomes that were reported in at least two trials were meta-analyzed; otherwise, a narrative synthesis was used for data analysis. Results A total of 27 trials were identified and analyzed. For primary outcomes, the use of mobile app-assisted self-care interventions was associated with significant reductions in HbA1c levels (standardized mean difference [SMD] −0.44, 95% CI −0.59 to −0.29; P<.001), SBP (SMD −0.17, 95% CI −0.31 to −0.03, P=.02), and DBP (SMD −0.17, 95% CI −0.30 to −0.03, P=.02). Subgroup analyses for primary outcomes showed that several intervention features were supportive of self-management, including blood glucose, blood pressure, and medication monitoring, communication with health care providers, automated feedback, personalized goal setting, reminders, education materials, and data visualization. In addition, 8 objective secondary outcomes were meta-analyzed, which showed that the interventions had significant lowering effects on fasting blood glucose levels and waist circumference. A total of 42 secondary outcomes were narratively synthesized, and mixed results were found. Conclusions Mobile app-assisted self-care interventions can be effective tools for managing blood glucose and blood pressure, likely because their use facilitates remote management of health issues and data, provision of personalized self-care recommendations, patient–care provider communication, and decision making. More studies are required to further determine which combinations of intervention features are most effective in improving the control of the diseases. Moreover, evidence regarding the effects of these interventions on the behavioral, knowledge, and psychosocial outcomes of patients is still scarce, which warrants further examination.


2020 ◽  
Author(s):  
Kaifeng Liu ◽  
Zhenzhen Xie ◽  
Calvin Kalun Or

UNSTRUCTURED Mobile app-assisted self-care interventions are emerging promising tools to support self-care of patients with chronic diseases such as type 2 diabetes and hypertension. The effectiveness of such interventions requires further exploration for more supporting evidence. A systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted to examine the effectiveness of mobile app-assisted self-care interventions developed for type 2 diabetes and/or hypertension in improving patient outcomes. We followed the Cochrane Collaboration guidelines and searched MEDLINE, Cochrane Library, EMBASE, and CINAHL Plus for relevant studies published between January 2007 and January 2019. Primary outcomes included changes in hemoglobin A<sub>1c</sub> (HbA<sub>1c</sub>) levels, systolic blood pressure (SBP), and diastolic blood pressure (DBP). Changes in other clinical-, behavioral-, knowledge-, and psychosocial-related outcomes were included as secondary outcomes. Primary outcomes and objective secondary outcomes that were reported in at least two trials were meta-analyzed; otherwise, a narrative synthesis was used for data analysis. A total of 27 trials were identified and analyzed. For primary outcomes, the use of mobile app-assisted self-care interventions was associated with significant reductions in HbA<sub>1c</sub> levels (standardized mean difference [SMD] −0.44, 95% CI −0.59 to −0.29; <i>P</i><.001), SBP (SMD −0.17, 95% CI −0.31 to −0.03, <i>P</i>=.02), and DBP (SMD −0.17, 95% CI −0.30 to −0.03, <i>P</i>=.02). Subgroup analyses for primary outcomes showed that several intervention features were supportive of self-management, including blood glucose, blood pressure, and medication monitoring, communication with health care providers, automated feedback, personalized goal setting, reminders, education materials, and data visualization. In addition, 8 objective secondary outcomes were meta-analyzed, which showed that the interventions had significant lowering effects on fasting blood glucose levels and waist circumference. A total of 42 secondary outcomes were narratively synthesized, and mixed results were found. Mobile app-assisted self-care interventions can be effective tools for managing blood glucose and blood pressure, likely because their use facilitates remote management of health issues and data, provision of personalized self-care recommendations, patient–care provider communication, and decision making. More studies are required to further determine which combinations of intervention features are most effective in improving the control of the diseases. Moreover, evidence regarding the effects of these interventions on the behavioral, knowledge, and psychosocial outcomes of patients is still scarce, which warrants further examination.


2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Abolfazl Mehbodniya ◽  
A. Suresh Kumar ◽  
Kantilal Pitambar Rane ◽  
Komal Kumar Bhatia ◽  
Bhupesh Kumar Singh

In patients with chronic diseases condition, mobile health monitoring facility proves to play a significant role in providing significant assistance toward personal management. This research examined the use of smartphones by diabetes patients and their intentions to apply them for self-care and monitoring as well as management. This cross-sectional survey-based study was conducted in Jul-Aug 2021 with 200 diabetic patients (especially type 2) who were visiting specialized clinics and hospitals of Gujrat state, India. A validated questionnaire survey was designed to collect data, which included questions about demographics, information pertaining to other, use of cellphones, the Internet, and the intention to implement smartphones for diabetes monitoring, self-care, and self-management. A highest number of studied participants have mobile phone (97.5%) and smartphones (87%) and access the Internet on daily basis (83.5%). Younger participants were more inclined to use smartphone apps and have also shown more interest for continuous use in the future ( p < 0.01 ). The majority of participants used apps for nutritional planning (85.5%), to monitor glucose control (76.5%), and for scheduling of diabetes appointments on the calendar (90.5%). Recommendations to use mobile app by doctors or healthcare profession were reported by 20.5% of the participants and attitude and future intention to use mobile apps were reported by the majority of participants. The majority of type 2 diabetes patients choose to use their cellphones and the internet or mobile phone reminder system for medication as well as to plan their diets, monitor their blood sugar levels, and communicate with their doctors. The findings of this research can be used to develop strategies and implement mHealth-based therapies to assist patients with type 2 diabetes to efficiently manage their health and might contribute to reducing patients’ out-of-pocket expenditure as well as reducing disability-adjusted life years (DAILY) attributed by DM.


2020 ◽  
Author(s):  
Kaifeng Liu ◽  
Zhenzhen Xie ◽  
Calvin Kalun Or

BACKGROUND Mobile app-assisted self-care interventions are emerging promising tools to support self-care of patients with chronic diseases such as type 2 diabetes and hypertension. The effectiveness of such interventions requires further exploration for more supporting evidence. OBJECTIVE A systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted to examine the effectiveness of mobile app-assisted self-care interventions developed for type 2 diabetes and/or hypertension in improving patient outcomes. METHODS We followed the Cochrane Collaboration guidelines and searched MEDLINE, Cochrane Library, EMBASE, and CINAHL Plus for relevant studies published between January 2007 and January 2019. Primary outcomes included changes in hemoglobin A<sub>1c</sub> (HbA<sub>1c</sub>) levels, systolic blood pressure (SBP), and diastolic blood pressure (DBP). Changes in other clinical-, behavioral-, knowledge-, and psychosocial-related outcomes were included as secondary outcomes. Primary outcomes and objective secondary outcomes that were reported in at least two trials were meta-analyzed; otherwise, a narrative synthesis was used for data analysis. RESULTS A total of 27 trials were identified and analyzed. For primary outcomes, the use of mobile app-assisted self-care interventions was associated with significant reductions in HbA<sub>1c</sub> levels (standardized mean difference [SMD] −0.44, 95% CI −0.59 to −0.29; <i>P</i><.001), SBP (SMD −0.17, 95% CI −0.31 to −0.03, <i>P</i>=.02), and DBP (SMD −0.17, 95% CI −0.30 to −0.03, <i>P</i>=.02). Subgroup analyses for primary outcomes showed that several intervention features were supportive of self-management, including blood glucose, blood pressure, and medication monitoring, communication with health care providers, automated feedback, personalized goal setting, reminders, education materials, and data visualization. In addition, 8 objective secondary outcomes were meta-analyzed, which showed that the interventions had significant lowering effects on fasting blood glucose levels and waist circumference. A total of 42 secondary outcomes were narratively synthesized, and mixed results were found. CONCLUSIONS Mobile app-assisted self-care interventions can be effective tools for managing blood glucose and blood pressure, likely because their use facilitates remote management of health issues and data, provision of personalized self-care recommendations, patient–care provider communication, and decision making. More studies are required to further determine which combinations of intervention features are most effective in improving the control of the diseases. Moreover, evidence regarding the effects of these interventions on the behavioral, knowledge, and psychosocial outcomes of patients is still scarce, which warrants further examination.


2018 ◽  
Author(s):  
Xue Mei Wang ◽  
Dan Liu ◽  
Mao Lin Du ◽  
Rui Qi Hao ◽  
Hui Qiu Zheng ◽  
...  

BACKGROUND Nonadherence to self-management is common among patients with type 2 diabetes (T2D) and often leads to severe complications. Short messages service (SMS) technology provides a practical medium for delivering content to address patients’ barriers to adherence. OBJECTIVE The aim of this study was to design a series of SMS intervention templates, and to evaluate the feasibility of the SMS through a short message quality evaluation questionnaire and to explore the intervention effect. METHODS 1. The SMS evaluation was assessed through the 10-point scale SMS Quality Assessment Questionnaire. 2. A randomized controlled trial was conducted. The patients in SMS intervention were randomly divided into intervention group (IG) and control group (CG), which received evaluated messages education and regular education, respectively. The intervention was divided into four phases, a telephone interview was conducted to evaluate the effectiveness of the intervention after each phase. The main outcome were changes in blood glucose and blood pressure (BP) and their control rates, and secondary outcomes were changes in diet, physical activity, weight control and other health-related behaviors. RESULTS 1. SMS design: 42 SMS text messages were designed to promote healthy behaviors in different stages of behavior change, covering four key domains: healthy knowledge, diet, physical activity, living habits and weight control. 2. SMS evaluation: The average score for healthy knowledge, diet, physical activity, living habits, weight control were 8.0 (SD 0.7), 8.5 (SD 0.6), 7.9 (SD 1.0), 8.0 (SD 0.7), and 8.4 (SD 0.9), respectively. 3. SMS intervention: A total of 146 people completed the four-phase intervention, including 72 in the CG and 74 in the IG. At the end of the intervention period, in the IG, the decrease in fasting blood glucose (FBG, mean 1.5mg/l [SD 3.0] vs 0.4 mg/l [SD 2.8], P=0.011), postprandial blood glucose (PBG, mean 5.8mg/l [SD 5.1] vs 4.2 mg/l [SD 4.7], P=0.028), systolic blood pressure (SBP, mean 9.1mmHg [SD 15.8] vs 2.2mmHg [SD 13.3], P=0.025), FBG control rate (45.9% vs 31.0%, P=0.046) and PBG control rate (57.8% vs 33.7%, P=0.002) were better than the CG. In self-behavior management, the changes of the weight control, diet and physical activity in the IG were better than those in the CG, and the average score of the IG was greater than that of the CG (1.1 vs [-0.3] ), P0.001). CONCLUSIONS The overall quality of SMS content is higher to meet the needs of patients; Diet, physical activity and weight control message need to be focused on push. SMS interventions contribute to the management of blood glucose and BP, and help to promote a series of healthy-related behaviors.


2020 ◽  
Author(s):  
Medina Abdulkadir Wehabrebi ◽  
Goitom Molalign Takele ◽  
Hiyab Teklemichael Kidane ◽  
Kahsu Gebrekirstos Gebrekidan ◽  
Birhan Gebresillassie Gebregiorgis

Abstract Background: The prevalence of Type 2 diabetes is increasing steadily at an alarming rate and Ethiopia is placed fourth among the top five countries of the Africa region according to the International diabetes federation. Regardless of its burden, the self-care behaviors are still unknown. This study is aimed to determine the level of diabetes self-care practice and factors associated with among Type 2 diabetes mellitus patients in public hospitals of Tigray region.Methods: Institution-based, cross-sectional study was conducted in six selected hospitals of Tigray region from January to February, 2020. Data was collected by trained nurses with a face to face interview method using Summary Diabetes Self-Care Activities (SDSCA). Bivariate and multivariate logistic regression was used to identify factors associated with self-care practices. Statistical significance was declared at P-value < 0.05.Results: A total of 570 patients with type 2 diabetes were included in this study. The mean age of the participant was 46 ± 14.6 years. Less than half (46.7%) of the participants has good diabetes self-care practices. Urban residency (AOR=2.79, 95% CI 1.858-4.205), age group above 64 years (AOR=2.384, 95% CI 1.258-4.518), not having formal education (AOR=2.616, 95% CI 1.337-4.518), having family or social support (AOR=1.878, 95% CI 1.243-2.837), duration DM above 10 years (AOR=2.325, 95% CI 1.224-4.418), having personal glucometer at home (AOR=5.9, 95% CI 2.790-12.764) were determinant factors of good diabetes self-care practice. Conclusion: the diabetes self-care practices in the region was found to be low. Health care providers might have to consider actions to act on the identified factors and improve self-care practices of the patients. Especially, focusing on caring and giving follow up services to younger adults and DM patients coming from a rural areas.


2019 ◽  
Vol 6 (3) ◽  
pp. 786
Author(s):  
Eda Dayakar ◽  
C. Sathya Sree ◽  
E. Sanjay

Background: Diabetes mellitus is a common health problem globally. Dyslipidaemia is a major risk factor to develop cardiovascular disease in diabetics. They present study was undertaken to find out the prevalence of dyslipidaemia in type 2 diabetic patients.Methods: The present study was a cross sectional study consisting of 46 (23 male and 23 female) known type 2 diabetes mellitus patients. Age, gender, duration of diabetes, body mass index (BMI) was recorder in all the diabetic patients.  Fasting blood glucose levels, total cholesterol, triglycerides, HDL, LDL, VLDL levels were measured using standard methods and recorded.Results: The average total cholesterol, triglycerides, LDL, HDL and VLDL were 200±42mg/dl, 169.62±89.79mg/dl, 132.45±36.38mg/dl,39.1±16.6mg/dl and 35.85±17.09mg/dl respectively. The incidence of occurrence of hypercholesterolemia was 58.6% and hypertriglyceridemia 36.9%. Increased levels of LDL were observed in 30 (65.2%) patients and reduced HDL was observed in 43 (93.4%) patients. The incidence rate of dyslipidaemia was higher in female diabetic patients when compared to male diabetic patients.Conclusions: Awareness on the dyslipidaemia and its risk factors should be provided to the type 2 diabetic patients as they are more prone to get cardiovascular disease and lipid profile also should be monitored regularly along with blood glucose levels.


2021 ◽  
Vol 14 (02) ◽  
pp. 82-89
Author(s):  
Ratna Yunita Sari ◽  
Umdatus Soleha ◽  
Erika Chandra Dewi

  Introduction: Diabetes self-care is an effort to control type 2 diabetes mellitus. Family support and self-efficacy are needed for elderly people with type 2 diabetes mellitus to increase independence in managing their disease. This study aims to determine the relationship between family support and self-efficacy with self-care behavior in the elderly with type 2 diabetes mellitus at the Elderly Posyandu in Wadungasri Village. Methods: This study is a quantitative study with a correlational analytic research design using a cross-sectional approach. The population in this study was 132 elderly with type 2 diabetes mellitus using a probability sampling method with a technique used simple random sampling and obtained a sample of 100 elderly DM type 2. Results: The results showed that most of the elderly have family support and good self-efficacy. with less self-care behavior. The results of the analysis using the Spearman rank test showed that family support was associated with self-care for people with diabetes mellitus type 2 (p-value = 0.006, ɑ = 0.05). The results of the Spearman rank test analysis showed that self-efficacy was related to self-care for people with diabetes mellitus type 2 (p-value = 0.001, ɑ = 0.05). Conclusion: Family support and self-efficacy gave to elderly people with type 2 diabetes mellitus can influence health behavior patterns that will make self-care behavior well.


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