Center for Health Information and Decision Systems, Robert H. Smith School of Business, University of Maryland, College Park, MD, USA.
Welldoc Inc, Columbia, MD, USA.
J Diabetes Sci Technol. 2022 Jul;16(4):804-811. doi: 10.1177/1932296820976409. Epub 2020 Dec 23.
Digital health solutions targeting diabetes self-care are popular and promising, but important questions remain about how these tools can most effectively help patients. Consistent with evidence of the salutary effects of note-taking in education, features that enable annotation of structured data entry might enhance the meaningfulness of the interaction, thereby promoting persistent use and benefits of a digital health solution.
To examine the potential benefits of note-taking, we explored how patients with type 2 diabetes used annotation features of a digital health solution and assessed the relationship between annotation and persistence in engagement as well as improvements in glycated hemoglobin (A1C). Secondary data from 3142 users of the BlueStar digital health solution collected between December 2013 and June 2017 were analyzed, with a subgroup of 372 reporting A1C lab values.
About a third of patients recorded annotations while using the platform. Annotation themes largely reflected self-management behaviors (diet, physical activity, medication adherence) and well-being (mood, health status). Early use of contextual annotations was associated with greater engagement over time and with greater improvements in A1C.
Our research provides preliminary evidence of the benefits of annotation features in a digital health solution. Future research is needed to assess the causal impact of note-taking and the moderating role of thematic content reflected in notes.
针对糖尿病自我护理的数字健康解决方案广受欢迎且前景广阔，但这些工具如何才能最有效地帮助患者，仍存在一些重要问题。在教育中，记笔记具有有益效果，这一证据表明，能够对结构化数据录入进行注释的功能可能会增强交互的意义，从而促进数字健康解决方案的持续使用和收益。
为了研究记笔记的潜在益处，我们探讨了 2 型糖尿病患者如何使用数字健康解决方案的注释功能，并评估了注释与参与持久性之间的关系，以及糖化血红蛋白（A1C）的改善情况。对 2013 年 12 月至 2017 年 6 月期间收集的 3142 名 BlueStar 数字健康解决方案用户的二级数据进行了分析，其中包括 372 名报告 A1C 实验室值的用户。
大约三分之一的患者在使用该平台时记录了注释。注释主题主要反映了自我管理行为（饮食、身体活动、药物依从性）和健康状况（情绪、健康状况）。在使用情境注释时，如果能尽早使用，那么随着时间的推移，患者的参与度会更高，A1C 的改善也会更大。
我们的研究为数字健康解决方案中的注释功能提供了初步的益处证据。未来需要进一步研究来评估记笔记的因果影响，以及笔记中反映的主题内容的调节作用。
