Rapid Evidence Review of Mobile Applications for Self-management of Diabetes
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Patients with diabetes lack information on which commercially available applications (apps) improve diabetes-related outcomes. We conducted a rapid evidence review to examine features, clinical efficacy, and usability of apps for self-management of type 1 and type 2 diabetes in adults.
Ovid/Medline and the Cochrane Database of Systematic Reviews were searched for systematic reviews and technology assessments. Reference lists of relevant systematic reviews were examined for primary studies. Additional searches for primary studies were conducted online, through Ovid/Medline, Embase, CINAHL, and ClinicalTrials.gov. Studies were evaluated for eligibility based on predetermined criteria, data were extracted, study quality was assessed using a risk of bias tool, information on app features was collected, and app usability was assessed. Results are summarized qualitatively.
Fifteen articles evaluating 11 apps were identified: six apps for type 1 and five apps for type 2 diabetes. Common features of apps included setting reminders and tracking blood glucose and hemoglobin A1c (HbA1c), medication use, physical activity, and weight. Compared with controls, use of eight apps, when paired with support from a healthcare provider or study staff, improved at least one outcome, most often HbA1c. Patients did not experience improvements in quality of life, blood pressure, or weight, regardless of app used or type of diabetes. Study quality was variable. Of the eight apps available for usability testing, two were scored “acceptable,” three were “marginal,” and three were “not acceptable.”
Limited evidence suggests that use of some commercially available apps, when combined with additional support from a healthcare provider or study staff, may improve some short-term diabetes-related outcomes. The impact of these apps on longer-term outcomes is unclear. More rigorous and longer-term studies of apps are needed.
This review was funded by the Agency for Healthcare Research and Quality (AHRQ). The protocol is available at: http://www.effectivehealthcare.ahrq.gov/topics/diabetes-mobile-devices/research-protocol.
KEY WORDSdiabetes telemedicine self-management consumer health informatics decision making
The authors gratefully acknowledge the following individuals: Ian Anderson, James Case, Lily Cook, Makalapua Motu’apuaka, Ryan McKenna, Ed Reid, and Leah Williams. The authors of this manuscript are responsible for its content. Statements in the manuscript do not necessarily represent the official views of or imply endorsement by AHRQ, U.S. Department of Health of Human Services (HHS), or the National Institutes of Health. Preliminary results of this review were presented at the AcademyHealth 10th Annual Conference on the Science of Dissemination and Implementation in Health on December 4, 2017.
This project was funded under Contract Nos. HHSA29020120004C and HHSA290201700003C from the Agency for Healthcare Research and Quality (AHRQ), U.S. Department of Health and Human Services (HHS). Dr. Ivlev was supported by National Library of Medicine Biomedical Informatics Training Grant #T15LM007088.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
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