The Use and Effectiveness of Mobile Phone Apps in Regulating the Self-Managing Behaviour of Adolescents with Type 1 Diabetes.

Abstract

Type 1 diabetes mellitus (TIDM) is a chronic health condition, which demands that patients adhere to strict and unrelenting regimens of care and self-control. Previous studies have shown that adolescents are the least likely demographic to adhere to these regimens, leading to heightened blood sugar levels and an increase in glycaemic events. Research has also shown that mobile telephony interventions may perform a crucial role in improving health outcomes for this service user group. This study explores the use and effectiveness of a specific type of mobile telephony intervention, the mobile health app, in regulating the self-managing behaviour of adolescents living with T1DM. The study incorporates a structured literature review (SLR) of five previously published empirical studies: two randomised controlled trials (RCTs) and three cohort studies. The results show that consistent monitoring of blood glucose levels through health apps is associated with improved metabolic control, greater knowledge about disease self-management, improved self-efficacy and high levels of user satisfaction. However, while there is ample evidence that mobile phone apps are effective in improving the self-monitoring behaviour of adolescents with T1DM, the results from the SLR are subject to conjecture. In particular, the results of three out of the five studies do not report any statistically significant changes in clinical outcomes for adolescents who have used mobile health apps. These findings suggest that the effectiveness of mobile health apps in improving self-monitoring behaviour is mitigated by a wide range of factors including app usage, socioeconomic status, body image and self-perceptions, the complexity of phone app design and the debilitating nature of disease management. This underlines the importance of ensuring that adolescents who use mobile phone apps have access to training and support. The findings in this study also suggest that healthcare providers should take account of the diverse motivations that shape the uptake and effectiveness of mobile health apps amongst this demographic.