Evaluation of Apps for Patients at Risk of Gestational Diabetes

Purpose/Objectives - Diabetes is one of the world's fastest growing medical conditions that is afecting both adults and newborns. Mobile applications might be an efective way to provide education and behavior tracking tools for pregnant mothers. In this this study we evaluated mobile apps against evaluation criteria to discover their applicability for patients at risk of gestational diabetes. This study assesses how well existing mobile apps on the market meet the information and tracking needs of patients with gestational diabetes. This study also evaluated the feasibility of how to integrate these apps into patient care. Methodology/Approach - We conducted a search of the mobile apps in the United States Apple iTunes store for mobile apps for Apple devices, and searched the Google Play store for Android devices that contained key words related to the following concepts of nutrition (diet), tracking, diabetes and pregnancy. For each of these apps we have two reviewers to look at the description of the tools to see if they include both information on nutrition relevant to diabetes in pregnant women and if they had any tools for tracking nutrition, blood sugar or exercise. Apps were included if both reviewers agreed on the inclusion or exclusion and if there was a discrepancy we used a third reviewer. Evaluation criteria was developed to assess the mobile apps on four dimensions. These dimensions were credibility and trust, education and information, interactive tools and behaviour tracking to promote patient engagement and usability and design methodology. Finding/Results - As of August 4, 2017, there are 42008 Apps classified in the Health category and 79577 classified in the Medical Category in the iTunes store. A search of the keywords related to nutrition, diabetes, pregnancy, and tracking resulted in 103 apps that were manually reviewed per our evaluation criteria for content and features. Previous to this study, it was not known how many mobile health applications were specifically developed for diabetes in pregnancy, how well these apps meet the information needs of these patients and how much evidence-based information was available in these apps. It was also unclear how much functionality these apps had for tracking nutrition, exercise and diabetes (sugar level, insulin) and if the mobile apps implemented any behavioral strategies. Conclusion/Implications/Recommendations - We found that there are very few apps that provided both comprehensive evidence-based educational content and tracking tools. This study demonstrates the need to develop apps that have more comprehensive content, tracking tools and ability to bidirectionally share data with the patient's primary care provider.This will require both technical adaptations and policy changes to allow for data sharing. Diabetes prevention apps for women with gestational diabetes have the potential to greatly impact patient care. Future development eforts must be made to include nutrition as a core component for diabetes prevention apps.