Zhang Yiyu, Li Xia, Luo Shuoming, Liu Chaoyuan, Liu Fang, Zhou Zhiguang
Department of Metabolism and Endocrinology, The Second Xiangya Hospital, Central South University, Changsha, China.
Key Laboratory of Diabetes Immunology, Ministry of Education, Changsha, China.
JMIR Mhealth Uhealth. 2018 Sep 21;6(9):e11400. doi: 10.2196/11400.
With the popularity of mobile phones, mobile apps have great potential for the management of diabetes, but the effectiveness of current diabetes apps for type 1 diabetes mellitus (T1DM) is poor. No study has explored the reasons for this deficiency from the users' perspective.
The aims of this study were to explore the perspectives and needs of T1DM patients and diabetes experts concerning a diabetes app and to design a new T1DM management mobile app.
A mixed-methods design combining quantitative surveys and qualitative interviews was used to explore users' needs and perspectives. Experts were surveyed at 2 diabetes conferences using paper questionnaires. T1DM patients were surveyed using Sojump (Changsha ran Xing InfoTech Ltd) on a network. We conducted semistructured, in-depth interviews with adult T1DM patients or parents of child patients who had ever used diabetes apps. The interviews were audio-recorded, transcribed, and coded for theme identification.
The expert response rate was 63.5% (127/200). The respondents thought that the reasons for app invalidity were that patients did not continue using the app (76.4%, 97/127), little guidance was received from health care professionals (HCPs; 73.2%, 93/127), diabetes education knowledge was unsystematic (52.8%, 67/127), and the app functions were incomplete (44.1%, 56/127). A total of 245 T1DM patient questionnaires were collected, of which 21.2% (52/245) of the respondents had used diabetes apps. The reasons for their reluctance to use an app were limited time (39%, 20/52), complicated operations (25%, 13/52), uselessness (25%, 13/52), and cost (25%, 13/52). Both the experts and patients thought that the most important functions of the app were patient-doctor communication and the availability of a diabetes diary. Two themes that were useful for app design were identified from the interviews: (1) problems with patients' diabetes self-management and (2) problems with current apps. In addition, needs and suggestions for a diabetes app were obtained. Patient-doctor communication, diabetes diary, diabetes education, and peer support were all considered important by the patients, which informed the development of a prototype multifunctional app.
Patient-doctor communication is the most important function of a diabetes app. Apps should be integrated with HCPs rather than stand-alone. We advocate that doctors follow up with their patients using a diabetes app. Our user-centered method explored comprehensively and deeply why the effectiveness of current diabetes apps for T1DM was poor and what T1DM patients needed for a diabetes app and provided meaningful guidance for app design.
随着手机的普及，移动应用程序在糖尿病管理方面具有巨大潜力，但目前的糖尿病应用程序对1型糖尿病（T1DM）的有效性较差。尚无研究从用户角度探讨这一缺陷的原因。
本研究旨在探讨T1DM患者和糖尿病专家对糖尿病应用程序的看法和需求，并设计一款新的T1DM管理移动应用程序。
采用定量调查和定性访谈相结合的混合方法设计，以探索用户的需求和观点。在2次糖尿病会议上使用纸质问卷对专家进行调查。通过网络使用问卷星（长沙冉星信息技术有限公司）对T1DM患者进行调查。我们对曾使用过糖尿病应用程序的成年T1DM患者或儿童患者的家长进行了半结构化的深入访谈。访谈进行了录音、转录，并进行编码以识别主题。
专家回复率为63.5%（127/200）。受访者认为应用程序无效的原因是患者未持续使用该应用程序（76.4%，97/127）、医疗保健专业人员（HCPs）提供的指导很少（73.2%，93/127）、糖尿病教育知识不系统（52.8%，67/127）以及应用程序功能不完整（44.1%，56/127）。共收集到245份T1DM患者问卷，其中21.2%（52/245）的受访者使用过糖尿病应用程序。他们不愿使用应用程序的原因是时间有限（39%，20/52）、操作复杂（25%，13/52）、无用（25%，13/52）和费用（25%，13/52）。专家和患者都认为应用程序最重要的功能是医患沟通和糖尿病日记的可用性。从访谈中确定了两个对应用程序设计有用的主题：（1）患者糖尿病自我管理的问题和（2）当前应用程序的问题。此外，还获得了对糖尿病应用程序的需求和建议。患者认为医患沟通、糖尿病日记、糖尿病教育和同伴支持都很重要，这些为多功能应用程序原型的开发提供了依据。
医患沟通是糖尿病应用程序最重要的功能。应用程序应与HCPs整合而不是独立存在。我们提倡医生使用糖尿病应用程序对患者进行随访。我们以用户为中心的方法全面深入地探讨了当前糖尿病应用程序对T1DM有效性差的原因以及T1DM患者对糖尿病应用程序的需求，并为应用程序设计提供了有意义的指导。
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