Integration of the Vision of People With Diabetes Into the Development Process to Improve Self-management via Diabetes Apps: Qualitative Interview Study

JMIR Diabetes · 6 authors, 5 centres

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TL;DR

Participants envisioned AI-driven blood glucose predictions, smartwatch-based alerts and real-time value display, improved communication features, and comprehensive information resources to support self-management and reduce stigma.

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Thematic analysis revealed that participants envisioned predictive AI-based blood glucose alerts, improvements in sensor signal loss and value delay via smartwatches, improved communication and information-sharing capabilities through chat and forum options, reliable information sources, and discreet smartwatch alerts. Participants also noted that current apps lack personalized information and fail to indicate when displayed values are delayed. Limitations include that only one stakeholder group's vision was assessed, interviews were used instead of focus groups due to COVID-19 restrictions, and systems such as insulin pumps and automated insulin delivery were not considered. The authors describe this vision assessment as a first step toward creating a shared vision among all relevant stakeholders to guide future diabetes app development.

STUDY TYPE

other

SPECIALTY

endocrinology

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AI pipeline

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100% · A

ORIGINAL PAPER

PMC10176130

Integration of the Vision of People With Diabetes Into the Development Process to Improve Self-management via Diabetes Apps: Qualitative Interview Study

JMIR Diabetes

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ABSTRACT

Abstract Background Diabetes is a major global epidemic and serious public health problem. Diabetes self-management is a 24/7 challenge for people with type 1 diabetes that influences their quality of life (QoL). Certain apps can support the self-management of people with diabetes; however, current apps do not meet the needs of people with diabetes appropriately, and their safety is not ensured. Moreover, there are a multitude of hardware and software problems associated with diabetes apps and regulations. Clear guidelines are required to regulate medical care via apps. In Germany, apps must undergo 2 examination processes to be listed in the Digitale Gesundheitsanwendungen directory. However, neither examination process considers whether the medical use of the apps is sufficient for users’ self-management. Objective This study aims to contribute to the technology development process of diabetes apps by exploring individual perspectives on desired features and content of diabetes apps among people with diabetes. The vision assessment conducted is a first step toward creating a shared vision among all relevant stakeholders. To ensure adequate research and development processes for diabetes apps in the future, guiding visions from all relevant stakeholders are required. Methods In a qualitative study, 24 semistructured interviews with patients with type 1 diabetes were conducted, among whom 10 (42%) were currently using an app. To clarify the perceptions of people with diabetes regarding the functions and content of diabetes apps, a vision assessment was conducted. Results People with diabetes have concrete ideas of features and content in apps to improve their QoL and allow them to live as comfortably as possible, such as informative predictions through artificial intelligence, improvements in signal loss and value delay through smartwatches, improved communication and information-sharing capabilities, reliable information sources, and user-friendly and discreet messaging options through smartwatches. In addition, according to people with diabetes, future apps should show improved sensors and app connectivity to avoid incorrect values being displayed. They also wish for an explicit indication that displayed values are delayed. In addition, personalized information was found to be lacking in apps. Conclusions People with type 1 diabetes want future apps to improve their self-management and QoL and reduce stigma. Desired key features include personalized artificial intelligence predictions of blood glucose levels, improved communication and information sharing through chat and forum options, comprehensive information resources, and smartwatch alerts. A vision assessment is the first step in creating a shared vision among stakeholders to responsibly guide the development of diabetes apps. Relevant stakeholders include patient organizations, health care professionals, insurers, policy makers, device manufacturers, app developers, researchers, medical ethicists, and data security experts. After the research and development process, new apps must be launched while considering regulations regarding data security, liability, and reimbursement. Keywords: people with type 1 diabetes, self-management, diabetes apps, vision assessment, anticipated stigma, qualitative research, Digitale Gesundheitsanwendungen, DiGA, mobile phone

CITATION EXPORT

Isabel Klemme, Kamil J Wrona, Irja Marije de Jong et al.. Integration of the Vision of People With Diabetes Into the Development Process to Improve Self-management via Diabetes Apps: Qualitative Interview Study. JMIR Diabetes. (2023). https://doi.org/10.2196/38474

AUTHORS

6 · 5 CENTRES

Isabel Klemme, Kamil J Wrona, Irja Marije de Jong, Christoph Dockweiler, Leona Aschentrup, Joanna Albrecht

1School of Public Health, Bielefeld University, Bielefeld, Germany
2Athena Institute, VU University Amsterdam, Amsterdam, Netherlands
3Faculty of Engineering and Mathematics, Bielefeld University of Applied Sciences, Bielefeld, Germany
4Faculty of Health, Bielefeld University of Applied Sciences, Bielefeld, Germany
5Department Digital Health Sciences and Biomedicine, School of Life Sciences, University of Siegen, Siegen, Germany