JMIR Publications

ABSTRACT

Background:

Diabetes apps represent a promising addition to face-to-face self-management interventions, which can be time and resource intensive. However, few randomised controlled trials have evaluated the efficacy of diabetes apps, in particular as a stand-alone intervention without additional clinical support.

Objective:

We used a parallel group randomised trial design to investigate user engagement of two commercially available apps (free versions of Glucose Buddy and mySugr) over two weeks. We hypothesised higher user engagement would be associated with improved self-care behaviours and illness beliefs in adults with type 2 diabetes (T2D).

Methods:

Adults with T2D attending outpatient diabetes clinics in Auckland were recruited and randomised (1:1 without blinding) to use either the Glucose Buddy or mySugr diabetes apps. User engagement and self-care behaviours (primary outcome measures) and illness beliefs (secondary outcome) were measured two weeks after baseline. Spearman’s correlations, Mann-Whitney U tests and Wilcoxon-signed ranks tests were used to explore associations between the outcome measures, as well as to investigate changes between and within groups. Six participants were interviewed to further explore acceptability and usability.

Results:

Fifty-eight participants (29/group) completed the two-week follow-up, out of which only 38 reported using the apps (Glucose Buddy = 20; mySugr = 18). Both groups reported low engagement (days used Mdn=4 for Glucose Buddy and Mdn=6.5 for mySugr, P=.06; minutes used Mdn=10 for both groups). No changes were observed in self-care or illness beliefs in either group. Out of the self-care behaviours, only blood glucose testing was significantly associated with minutes of app use (P=.02). The interviews suggested that although both apps were deemed acceptable, they were generally viewed as time-consuming and complex to use.

Conclusions:

Low engagement with both Glucose Buddy and mySugr reflect the challenges associated with engaging users with diabetes apps. The results highlight the need for more clinical support as well as involvement from end users and behaviour change specialists in order to incorporate evidence-based behaviour change techniques to motivate and provide value to users. Clinical Trial: Registered with Australia New Zealand Clinical Trials Registry on March 23rd 2018 (ACTRN12618000424202).