Assessing the quality of mobile applications in chronic disease management: a scoping review

AbstractWhile there has been a rapid growth of digital health apps to support chronic diseases, clear standards on how to best evaluate the quality of these evolving tools are absent. This scoping review aims to synthesize the emerging field of mobile health app quality assessment by reviewing criteria used by previous studies to assess the quality of mobile apps for chronic disease management. A literature review was conducted in September 2017 for published studies that use a set of quality criteria to directly evaluate two or more patient-facing apps supporting promote chronic disease management. This resulted in 8182 citations which were reviewed by research team members, resulting in 65 articles for inclusion. An inductive coding schema to synthesize the quality criteria utilized by included articles was developed, with 40 unique quality criteria identified. Of the 43 (66%) articles that reported resources used to support criteria selection, 19 (29%) used clinical guidelines, and 10 (15%) used behavior change theory. The most commonly used criteria included the presence of user engagement or behavior change functions (97%, n = 63) and technical features of the app such as customizability (20%, n = 13, while Usability was assessed by 24 studies (36.9%). This study highlights the significant variation in quality criteria employed for the assessment of mobile health apps. Future methods for app evaluation will benefit from approaches that leverage the best evidence regarding the clinical impact and behavior change mechanisms while more directly reflecting patient needs when evaluating the quality of apps.

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The Use of Health IT for Chronic Disease Management: A comprehensive review of diabetes applications used for self-management of the disease (Preprint)

10.2196/preprints.17431 ◽

2019 ◽

Author(s):

Lorrin Robinson ◽

Jamesa Hogges ◽

Ingrid Brown ◽

Kennedy Craig ◽

Akasha Lawrence ◽

...

Keyword(s):

Chronic Disease ◽

Disease Management ◽

Mobile Health ◽

Chronic Disease Management ◽

The Self ◽

Self Management ◽

Consumer Reviews ◽

Health Apps ◽

Apple Ios ◽

Mobile Health Apps

BACKGROUND Mobile health (mHealth) smartphone applications (apps) have shown promise in the self-management of chronic disease. Management of key disease variances can be performed through these applications to increase patient engagement in disease self-management. In today’s oversaturated health app market, what selection criteria do consumers employ to choose mobile health apps for disease self-management? App quality is critical in monitoring disease controls but is often linked to consumer popularity rather clinical recommendations of effectiveness in disease management. This paper provides a comprehensive review of features found in mobile health apps frequently used in the self-management of diabetes. OBJECTIVE The objective of this study was to review features of frequently used and high consumer-rated mobile health apps used in the self-management of diabetes within the Apple iOS store. These applications were cross-referenced against high consumer-rated health apps found in other online diabetes sources. This study aimed to highlight key features of consumer-favored mobile health apps used in the self-management of diabetes. METHODS A primary Apple iOS store search was conducted using the term “diabetes apps” on an Apple iPad. The top five most frequently used mobile health apps were identified and rated by the number of consumer reviews, application ratings, and the presence of key diabetes management features: dietary blood glucose, A1C, insulin, physical activity and prescription medication. A subsequent Google search was conducted using the search term “best Apple diabetes apps”. The top three search results – Healthline, Everyday Health, and Diabetes Apps, American Diabetes Association – were explored. The top five frequently used apps among those sources were examined against the same Apple iOS criteria. RESULTS Twelve mobile health apps were reviewed in total due to repetition in popularity across the four evaluated sources. Only one health app – Glucose Buddy Diabetes Tracker – appeared most frequently used within the Apple iOS store and across the other three sources. The OneTouch Reveal app ranked first on the list in the iOS store with 39,000 consumer reviews and a rating of 4.7 out of 5.0 stars while only appearing once among the other sources. Blood glucose tracking was evident across all apps, but other disease management features varied in type with at least three of the five key features being present across the 12 reviewed apps. Subscription costs and integration needs were present which could play a major role in consumer app selection. While mobile app preference was assessed and defined by the number of consumer reviews and star ratings, there were no scientific standards used in the selection and ranking of the health apps within this study. CONCLUSIONS Mobile health applications (apps) have shown promise in chronic disease management, but a surge in development of these non-regulated health solutions points to a need for standards in quality. A governing body of health information technology, clinical, policymaking, and other industry stakeholders, including patients, could be beneficial in defining health application standards for effective chronic disease management. Variabilities in features, cost, and other management inconsistencies could be diminished by regulatory uniformity and increase both patient engagement activities and disease outcomes.

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Self-management factors associated with quality of life among women with endometriosis: a cross-sectional Australian survey

Human Reproduction ◽

10.1093/humrep/deaa330 ◽

2020 ◽

Author(s):

Rebecca O’Hara ◽

Heather Rowe ◽

Jane Fisher

Keyword(s):

Quality Of Life ◽

Chronic Disease ◽

Disease Management ◽

Self Efficacy ◽

Chronic Disease Management ◽

Self Management ◽

Cross Sectional ◽

Female Population ◽

Management Factors

Abstract STUDY QUESTION What self-management factors are associated with quality of life among women with endometriosis? SUMMARY ANSWER Greater self-efficacy was associated with improved physical and mental quality of life. WHAT IS KNOWN ALREADY Women with endometriosis have an impaired quality of life compared to the general female population. However, most studies have investigated quality of life in a hospital or clinic setting rather than a community setting and the association between self-management factors and quality of life have not, to date, been investigated. STUDY DESIGN, SIZE, DURATION A cross-sectional, population-based online survey was performed, which was advertised through women’s, community and endometriosis-specific groups. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 620 women completed the survey for this study. Mental and physical quality of life was assessed using the standardized SF36v2 questionnaire. Self-management factors included self-efficacy, partners in health (active involvement in managing the condition) and performance of self-care activities. Treatment approaches included the use of hormonal treatment, pain medications and complementary therapies and whether the participant had a chronic disease management plan. Hierarchical regression analyses were used to examine whether self-management and treatment factors were associated with quality of life. MAIN RESULTS AND THE ROLE OF CHANCE Both physical and mental quality of life were significantly lower among women with endometriosis compared to the mean scores of the general Australian female population (P < 0.001). Physical quality of life was positively associated with income sufficiency (P < 0.001) and greater self-efficacy (P < 0.001), but negatively associated with age (P < 0.001), pain severity (P < 0.001), use of prescription medications (P < 0.001), having a chronic disease management plan (P < 0.05) and number of self-care activities (P < 0.05). Mental quality of life was positively associated with being older (P < 0.001), partnered (P < 0.001), having a university education (P < 0.05), increasing self-efficacy (P < 0.001) and higher partners in health scores (P < 0.001). LIMITATIONS, REASONS FOR CAUTION Results are derived from a cross-sectional study and can only be interpreted as associations not as causal relationships. The sample was more educated, more likely to speak English and be born in Australia than the general Australian female population of the same age, which may influence the generalizability of these results. WIDER IMPLICATIONS OF THE FINDINGS This study investigated a knowledge gap by investigating quality of life of women with endometriosis in a large community sample. Self-efficacy was significantly associated with both physical and mental quality of life. Supporting women with endometriosis to improve self-efficacy through a structured chronic disease management programme may lead to improvements in this aspect of wellbeing. STUDY FUNDING/COMPETING INTEREST(S) R.O. undertook this research as part of her PhD at Monash University, which was supported by an Australian Government Research Training Program Stipend. J.F. is the Finkel Professor of Global Public Health, which was supported by the Finkel Family Foundation. There are no conflicts of interest to declare. TRIAL REGISTRATION NUMBER NA.

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Incorporating Behavioral Trigger Messages Into a Mobile Health App for Chronic Disease Management: Randomized Clinical Feasibility Trial in Diabetes

JMIR mhealth and uhealth ◽

10.2196/15927 ◽

2020 ◽

Vol 8 (3) ◽

pp. e15927

Author(s):

Scott Sittig ◽

Jing Wang ◽

Sriram Iyengar ◽

Sahiti Myneni ◽

Amy Franklin

Keyword(s):

Chronic Disease ◽

Disease Management ◽

Mobile Health ◽

Self Efficacy ◽

Chronic Disease Management ◽

Text Messages ◽

Feasibility Trial ◽

Significant Difference ◽

Within Subjects ◽

The Impact

Background Although there is a rise in the use of mobile health (mHealth) tools to support chronic disease management, evidence derived from theory-driven design is lacking. Objective The objective of this study was to determine the impact of an mHealth app that incorporated theory-driven trigger messages. These messages took different forms following the Fogg behavior model (FBM) and targeted self-efficacy, knowledge, and self-care. We assess the feasibility of our app in modifying these behaviors in a pilot study involving individuals with diabetes. Methods The pilot randomized unblinded study comprised two cohorts recruited as employees from within a health care system. In total, 20 patients with type 2 diabetes were recruited for the study and a within-subjects design was utilized. Each participant interacted with an app called capABILITY. capABILITY and its affiliated trigger (text) messages integrate components from social cognitive theory (SCT), FBM, and persuasive technology into the interactive health communications framework. In this within-subjects design, participants interacted with the capABILITY app and received (or did not receive) text messages in alternative blocks. The capABILITY app alone was the control condition along with trigger messages including spark and facilitator messages. A repeated-measures analysis of variance (ANOVA) was used to compare adherence with behavioral measures and engagement with the mobile app across conditions. A paired sample t test was utilized on each health outcome to determine changes related to capABILITY intervention, as well as participants’ classified usage of capABILITY. Results Pre- and postintervention results indicated statistical significance on 3 of the 7 health survey measures (general diet: P=.03; exercise: P=.005; and blood glucose: P=.02). When only analyzing the high and midusers (n=14) of capABILITY, we found a statistically significant difference in both self-efficacy (P=.008) and exercise (P=.01). Although the ANOVA did not reveal any statistically significant differences across groups, there is a trend among spark conditions to respond more quickly (ie, shorter log-in lag) following the receipt of the message. Conclusions Our theory-driven mHealth app appears to be a feasible means of improving self-efficacy and health-related behaviors. Although our sample size is too small to draw conclusions about the differential impact of specific forms of trigger messages, our findings suggest that spark triggers may have the ability to cue engagement in mobile tools. This was demonstrated with the increased use of capABILITY at the beginning and conclusion of the study depending on spark timing. Our results suggest that theory-driven personalization of mobile tools is a viable form of intervention. Trial Registration ClinicalTrials.gov NCT04132089; http://clinicaltrials.gov/ct2/show/NCT004122089

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Comparison of the Quality of Chronic Disease Management Between Adults With and Without Dementia

JAMA Network Open ◽

10.1001/jamanetworkopen.2021.9622 ◽

2021 ◽

Vol 4 (5) ◽

pp. e219622

Author(s):

Hiroshi Gotanda ◽

Teryl Nuckols ◽

Kanon Mori ◽

Yusuke Tsugawa

Keyword(s):

Chronic Disease ◽

Disease Management ◽

Chronic Disease Management

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Outcomes and opportunities: a nurse-led model of chronic disease management in Australian general practice

Australian Journal of Primary Health ◽

10.1071/py11164 ◽

2013 ◽

Vol 19 (2) ◽

pp. 150 ◽

Cited By ~ 19

Author(s):

Diann S. Eley ◽

Elizabeth Patterson ◽

Jacqui Young ◽

Paul P. Fahey ◽

Chris B. Del Mar ◽

...

Keyword(s):

Quality Of Life ◽

General Practice ◽

Chronic Disease ◽

Disease Management ◽

Chronic Disease Management ◽

Models Of Care ◽

Practice Nurses ◽

Australian General Practice ◽

General Practices

The Australian government’s commitment to health service reform has placed general practice at the centre of its agenda to manage chronic disease. Concerns about the capacity of GPs to meet the growing chronic disease burden has stimulated the implementation and testing of new models of care that better utilise practice nurses (PN). This paper reports on a mixed-methods study nested within a larger study that trialled the feasibility and acceptability of a new model of nurse-led chronic disease management in three general practices. Patients over 18 years of age with type 2 diabetes, hypertension or stable ischaemic heart disease were randomised into PN-led or usual GP-led care. Primary outcomes were self-reported quality of life and perceptions of the model’s feasibility and acceptability from the perspective of patients and GPs. Over the 12-month study quality of life decreased but the trend between groups was not statistically different. Qualitative data indicate that the PN-led model was acceptable and feasible to GPs and patients. It is possible to extend the scope of PN care to lead the routine clinical management of patients’ stable chronic diseases. All GPs identified significant advantages to the model and elected to continue with the PN-led care after our study concluded.

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