A Framework to Assist Health Professionals in Recommending High-Quality Apps for Supporting Chronic Disease Self-Management: Illustrative Assessment of Type 2 Diabetes Apps

This is a review for Kelli Hale, Sandra Capra, and Judith Bauer's recommendations on High-Quality apps for supporting Type 2 Diabetes self-management.

Introduction

Mobile Health or MHealth represents an innovative path to help self-manage patients suffering from chronic diseases. However, although it is a promising market, how can a physician asses and be sure on which of the current applications in the digital market is the most optimal to provide to his/her patient with the tools required to improve his quality of life. This paper considers different factors crucial in the election of an application to help manage patients chronic status. The main objective from the study is to provide those applications which provide their information to patients from evidence-based programs, consistent with behavioral theory, as well as a patient-centered approach for matching apps to patients' individual needs.

Methods

A three-step framework was established for the conduction of the study:

The first step was the Selection or Identification which elected the most popular highest quality apps in which their content was based on evidence-based information. Apps were selected based on the following inclusion criteria:(1) consistent with the 29 app topics, (2) less than AUD $5, and (3) written in English.

Second, the categorization based on topics and core intervention strategies. Core intervention strategies of each app were identified by using the Behaviour Theory Content Survey (BTS).

Third, a patient centered-approach was taken into consideration to match the patients needs based on problem etiology and patient motivation.

Results

App Identification: From the top 200 free and grossing apps only 4 were recovered. Two were exercise apps and two were diet-focused apps; Interestingly, none of the results were specific to diabetes.

App Categorization: Five categories were yielded from the vast list of apps including Healthy eating, Physical activity, Self-monitoring, Problem solving, and Healthy coping. With Healthy eating and Physical activity been the categories with the most apps. Scores from the BTS were significantly low, since the max possible score was a 100 been 24.4 the mean total score.

App Patient Needs: The third step consisted on basically allocating the patient into the different categories established by step two; There was no single common patient-need specific to a single category the results indicated that indeed patient needs couldn't be associated to a category.

Conclusion

Most of the applications provided in their content general information and assistance to their users, but were limited in assessment, feedback, or tailored assistance. Results also show that apps incorporated some degree of interaction with the users as an intervention strategy, but the emotional and cognitive areas were very underdeveloped or simply not present, an aspect believed to be crucial for the motivation of the use of technology by men. Although the study suggest that the chronic treatment of a patient would improve significantly by customizing the application to the patients-needs it wouldn't be feasible for the app developer to materialize a software so exclusive since it would also affect the range in the market for him. Also, its incredible the degree of evolution of applications in the categories of social media, news, games, business or education while having no substantial development in the category of Health applications, specifically for the improvement of chronic health illnesses.