Exploration of Users’ Perspectives and Needs and Design of a Type 1 Diabetes Management Mobile App: Mixed-Methods Study

Abstract

BackgroundWith the popularity of mobile phones, mobile apps have great potential for the management of diabetes, but the effectiveness of current diabetes apps for type 1 diabetes mellitus (T1DM) is poor. No study has explored the reasons for this deficiency from the users’ perspective.ObjectiveThe aims of this study were to explore the perspectives and needs of T1DM patients and diabetes experts concerning a diabetes app and to design a new T1DM management mobile app.MethodsA mixed-methods design combining quantitative surveys and qualitative interviews was used to explore users’ needs and perspectives. Experts were surveyed at 2 diabetes conferences using paper questionnaires. T1DM patients were surveyed using Sojump (Changsha ran Xing InfoTech Ltd) on a network. We conducted semistructured, in-depth interviews with adult T1DM patients or parents of child patients who had ever used diabetes apps. The interviews were audio-recorded, transcribed, and coded for theme identification.ResultsThe expert response rate was 63.5% (127/200). The respondents thought that the reasons for app invalidity were that patients did not continue using the app (76.4%, 97/127), little guidance was received from health care professionals (HCPs; 73.2%, 93/127), diabetes education knowledge was unsystematic (52.8%, 67/127), and the app functions were incomplete (44.1%, 56/127). A total of 245 T1DM patient questionnaires were collected, of which 21.2% (52/245) of the respondents had used diabetes apps. The reasons for their reluctance to use an app were limited time (39%, 20/52), complicated operations (25%, 13/52), uselessness (25%, 13/52), and cost (25%, 13/52). Both the experts and patients thought that the most important functions of the app were patient-doctor communication and the availability of a diabetes diary. Two themes that were useful for app design were identified from the interviews: (1) problems with patients’ diabetes self-management and (2) problems with current apps. In addition, needs and suggestions for a diabetes app were obtained. Patient-doctor communication, diabetes diary, diabetes education, and peer support were all considered important by the patients, which informed the development of a prototype multifunctional app.ConclusionsPatient-doctor communication is the most important function of a diabetes app. Apps should be integrated with HCPs rather than stand-alone. We advocate that doctors follow up with their patients using a diabetes app. Our user-centered method explored comprehensively and deeply why the effectiveness of current diabetes apps for T1DM was poor and what T1DM patients needed for a diabetes app and provided meaningful guidance for app design.

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“…Furthermore, besides engagement, the metrics inform about the amount of data collected and reflect the availability of rich health information. Previous studies showed that both patients and diabetologists thought that diaries and doctor-patient communication based on collected data were the most important features of apps for diabetes [ 28 , 39 ]. On the other hand, we found that the medication, food, and BG modules had a higher proportion of users than the other modules, potentially because the manual data entry mode makes it possible for any person with diabetes to register data (for the BG module, a BG meter is necessary, but these are very common for people with diabetes).…”

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“…A higher score indicated more standardized prevention and control of in-hospital infection; 5) To "pass" the survey, the KAP scores have to be higher than 7, 24, and 36, respectively. This survey was conducted via a questionnaire, which was distributed to eligible subjects via a Sojump link and could be completed by the participants in approximately 8-10 minutes [13,14]. Any question about the questionnaire was addressed by the investigator through telephone communication, etc.…”

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“…This corresponds with previous works performed in different specialties. For example, a previous survey among people living with type 1 diabetes mellitus found that 40% of respondents reported being aware of self-management apps 12. Alongside the value of apps in patient self-empowerment, they can also facilitate patient communication with health professionals,13 improve treatment adherence,14 provide condition-specific education and enable remote condition monitoring 15 16…”