Dillys Larbi, Norway
Universitetssykehuset Nord-Norge Norwegian Centre for E-health ResearchPresenter of 2 Presentations
INTERVENTION STUDIES NEED TO ADAPT TO ADDRESS PATIENT NEEDS FOR DIABETES SELF-MANAGEMENT
Abstract
Background and Aims
Research on health technologies traditionally report clinical measures. However, with mHealth and online resources for diabetes self-management, individuals are calling for more, diverse evidence. We compare two reviews to determine to what extent mHealth and online intervention studies address patient-reported needs.
Methods
A systematic review (Review 1) searched for reported outcomes of mHealth and online intervention studies (PROSPERO registration: CRD42018115246). A literature review (Review 2) searched for patient-reported needs for diabetes self-management. Both covered articles published between 2015 and 2019. For ease of comparison, the co-authors categorized the results.
Results
Reviews 1 and 2 resulted in n=31 and n=21 articles, respectively. Main categories of reported outcomes were: support from/access to resources, usability/suitability, patient empowerment/engagement, clinical outcomes, and data protection. Main needs categories were: support/access to services, information, coping and patient engagement/empowerment, and technology. Thus, the research outcomes and patient needs were in general very different. For example, under the category support/access to services, reported intervention outcomes included peers, coordinated-care services and relevant information. However, specific patient-reported needs included resources and services to self-management activities, e.g. gyms, feedback on self-management performance and reminders.
Conclusions
A reason for these differences is that research interventions occur within closed and controllable systems, whereas patient-reported needs result from experience in the real-world, with a multitude of resources. Future interventions can address this by include more contextual information, e.g. about participants’ access to resources, as baseline measures. In doing so, we can provide evidence of the relationship that these resources have on the success of the intervention.
HOW TO CHOOSE AMONG THE MANY DIABETES APPS AND ONLINE RESOURCES?
Abstract
Background and Aims
Apps and online resources for diabetes self-management are overwhelmingly diverse. Therefore, the task of choosing the most trustworthy and best resources for one’s needs and preferences is challenging. We present interview results regarding how various stakeholders choose diabetes self-management resources.
Methods
We conducted semi-structured interviews with stakeholders (n=11) in Norway (2 participants with diabetes; 2 informal caregivers (e.g. family); 2 researchers; 2 policymakers; 2 healthcare professionals (HCPs); 1 developer) and analysed responses using thematic analysis. We asked how they choose apps and online resources to use, recommend or develop, including which characteristics they consider favourable.
Results
Policymakers and HCPs prefer apps and online resources with quality-assured information. Researchers choose apps based on scientists’ and developers’ recommendations, focusing on apps that function on multiple platforms and contain quality content. The developer chooses efficient and easy-to-use apps based on reports on trends and projects. Informal caregivers were influenced by peer recommendations, focusing on apps with remote-monitoring and tailorability, e.g.: “We have mainly chosen apps when we could influence the development or develop ourselves … we have probably not gone for apps that are verified then, but they're verified through widespread use by users”. Participants with diabetes choose resources that address their self-management foci; do not request access to private information; and provide automatic data-recording and blood-glucose graphs.
Conclusions
The various stakeholders have different foci when choosing diabetes apps and online resources. Researchers and health authorities should disseminate evidence-based guidelines on stakeholder-specific platforms to assist stakeholders to develop, recommend or use validated and trustworthy self-management resources.