The few touch digital diabetes diary : user-involved design of mobile self-help tools for peoplewith diabetes

Paper number 2, 4, 5 and 7 are not available in Munin, due to publishers' restrictions: 2. Årsand E, and Demiris G.: "User-Centered Methods for Designing Patient-Centric Self-Help Tools", Informatics for Health and Social Care, 2008 Vol. 33, No. 3, Pages 158-169 (Informa Healthcare). Available at http://dx.doi.org/10.1080/17538150802457562 4. Årsand E, Olsen OA, Varmedal R, Mortensen W, and Hartvigsen G.: "A System for Monitoring Physical Activity Data Among People with Type 2 Diabetes", pages 173-178 in S.K. Andersen, et.al. (eds.) "eHealth Beyond the Horizon - Get IT There", Proceedings of MIE2008, Studies in Health Technology and Informatics, Volume 136, May 2008, ISBN: 978-1-58603-864-9 5. Årsand E, Tufano JT, Ralston J, and Hjortdahl P.: "Designing Mobile Dietary Management Support Technologies for People with Diabetes", Journal of Telemedicine and Telecare, 2008 Volume 14, Number 7, Pp. 329-332 (Royal Society of Medicine Press). Available at http://dx.doi.org/10.1258/jtt.2008.007001 7. Årsand E, Walseth OA, Andersson N, Fernando R, Granberg O, Bellika JG, and Hartvigsen G.: "Using Blood Glucose Data as an Indicator for Epidemic Disease Outbreaks", pages 199-204 in R. Engelbrecht et.al. (eds.): "Connecting Medical Informatics and Bio-Informatics", Proceedings of MIE2005, Studies in Health Technology and Informatics, Volume 116, August 2005, ISBN: 978-1-58603-549-5. Check availabilityParadoxically, the technological revolution that has created a vast health problem due to a drastic change in lifestyle also holds great potential for individuals to take better care of their own health. The first consequence is not addressed in this dissertation, but the second represents the focus of the work presented, namely utilizing ICT to support self-management of individual health challenges. As long as only 35% of the patients in Norway achieve the International Diabetes Federation‟s goal for blood glucose (HbA1c), actions and activities to improve blood glucose control and related factors are needed. The presented work focuses on the development and integration of alternative sensor systems for blood glucose and physical activity, and a fast and effortless method for recording food habits. Various user-interface concepts running on a mobile terminal constitute a digital diabetes diary, and the total concept is referred to as the “Few Touch application”. The overall aim of this PhD project is to generate knowledge about how a mobile tool can be designed for supporting lifestyle changes among people with diabetes. Applying technologies and methods from the informatics field has contributed to improved insight into this issue. Conversely, addressing the concrete use cases for people with diabetes has resulted in the achievement of ICT designs that have been appreciated by the cohorts involved. Cooperation with three different groups of patients with diabetes over several years and various methods and theories founded in computer science, medical informatics, and telemedicine have been combined in design and research on patient-oriented aids. The blood glucose Bluetooth adapter, the step counter, and the nutrition habit registration system that have been developed were all novel and to my knowledge unique designs at the time they were first tested, and this still applies to the latter two. Whether it can be claimed that the total concept presented, the Few Touch application, will increase quality of life, is up to future research and large-scale tests of the system to answer. However, results from the Type 2 diabetes half-year study showed that several of the participants did adjust their medication, food habits and/or physical activity due to use of the application

Do mobile phone applications improve glycemic control (HbA1c) in the self-management of diabetes? A systematic review, meta-analysis, and GRADE of 14 randomized trials

OBJECTIVE To investigate the effect of mobile phone applications (apps) on glycemic control (HbA1c) in the self-management of diabetes. RESEARCH DESIGN AND METHODS Relevant studies that were published between 1 January 1996 and 1 June 2015 were searched from five databases: Medline, CINAHL, Cochrane Library, Web of Science, and Embase. Randomized controlled trials that evaluated diabetes apps were included. We conducted a systematic review with meta-analysis and GRADE (Grading of Recommendations Assessment, Development and Evaluation) of the evidence. RESULTS Participants from 14 studies (n = 1,360) were included and quality assessed. Although there may have been clinical diversity, all type 2 diabetes studies reported a reduction in HbA1c. The mean reduction in participants using an app compared with control was 0.49% (95% Cl 0.30, 0.68; I2 = 10%), with a moderate GRADE of evidence. Subgroup analyses indicated that younger patients were more likely to benefit from the use of diabetes apps, and the effect size was enhanced with health care professional feedback. There was inadequate data to describe the effectiveness of apps for type 1 diabetes. CONCLUSIONS Apps may be an effective component to help control HbA1c and could be considered as an adjuvant intervention to the standard self-management for patients with type 2 diabetes. Given the reported clinical effect, access, and nominal cost of this technology, it is likely to be effective at the population level. The functionality and use of this technology need to be standardized, but policy and guidance are anticipated to improve diabetes self-management care

Mobile Telemedicine for Diabetes Care

Diabetes Mellitus is nowadays one of the most frequent non-contagious diseases in the world and remains a major health problem for the national health care programs. It is well proved that Telemedicine helps diabetic patients controlling their glucose levels, facilitating their day to-day therapy management and the communication with health care personnel. The rapid growth and development of information technologies in the areas of mobile computing and mobile Internet is shaping a new technological scenario of telemedicine and shared care systems. In this chapter we will show one approach to Mobile Telemedicine for Diabetes Care

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Pervasive healthcare in lived experience : thinking beyond the home : position paper for workshop on pervasive healthcare in the home.

The National Health Service (NHS) in the UK, like many other public heath services worldwide, is facing a number of key challenges. Among them are an ageing population and a rising incidence of chronic health conditions. This situation requires a radical re-examination of how people manage their health and their healthcare in ways that challenge the relationship between people and healthcare services. Combining this observation with the opportunities afforded by pervasive information and communication technologies, we argue that design research should reach beyond simply locating devices and services to offer healthcare ‘in the home’ and should examine this broader agenda. Rather than focussing design discourse on the specifics of one location, we should adopt a holistic view, beginning from people’s lived experience. In this position paper we describe the User-Centred Healthcare Design (UCHD) project, a 5-year collaboration between universities and NHS Trusts in South Yorkshire, UK. We suggest that new models of healthcare that re-define the institutional and social context of care are required if we are to meet the challenge of chronic illness. We describe our progress to date on the UCHD project, our commitment to placing patient experience at the centre of design, and our initial experiences of using an experience-based co-design method to improve outpatient services in a Sheffield hospital

Usage of mobile applications in diabetes management: a review

Peer-reviewed articles on the usage of mobile applications in the management of diabetes were reviewed. Studies using mobile device applications for diabetes interventions published between January 2007 and March 2013 were included in this review. Studies related to the developmental processes of the mobile applications were excluded. The characteristics of these studies and the outcomes of the methods used in the management of diabetes were gathered. We retrieved a total of 372 articles from ACM Digital library, PubMed and Proquest Medical Library. After applying the inclusion and exclusion criteria, 8 articles were eligible for further review. Most of the studies included in this review showed the effectiveness of mobile applications in diabetes management. Their major contribution comes from feedback functions of the systems that assist participants in the self-monitoring of their blood glucose and dietary intake. However, the majority of the studies showed the limited use of the mobile phone as a tool to input information into systems which would in turn convey a reminder message to the patient. In conclusion, with its features of portability and convenience, mobile application used in the management of diabetes has the potential to improve glycaemic control, resulting in significant clinical and financial benefits

A mHealth Architecture for Diabetes Self-Management System

Recent advancement in smartphones coupled with the proliferation of data connectivity has resulted in increased interest and unprecedented growth in mobile applications for diabetes self-management. Nevertheless, a review of the literature highlights critical gaps between available functionality and user requirements and expectations. In this paper, we present a mHealth architecture of diabetes self-management system. The architecture has the following functionalities: automated data-entry through the use of wireless sensors; adherence to clinical guidelines; advanced statistical techniques for diabetes modeling and prediction; and advanced charting capabilities for data presentation and quality control

The impact of mobile monitoring technologies on glycosylated hemoglobin in diabetes: a systematic review

Background: A new development in the field of telehealth is the use of mobile health technologies (mhealth) to help patients record and track medical information. Mhealth appears particularly advantageous for conditions that require intense and ongoing monitoring, such as diabetes, and where people are of working age and not disabled. This review aims to evaluate the evidence for the effectiveness of mhealth interventions in diabetes management on glycosylated hemoglobin. Method: A comprehensive search strategy was developed and applied to eight electronic databases to identify studies that investigated the clinical effectiveness of mobile-based applications that allowed patients to record and send their blood glucose readings to a central server. The eligibility of 8543 papers was assessed against the selection criteria, and 24 papers were reviewed. All studies reviewed were assessed for quality using a standardized quality assessment tool. Results: Results for patients with type 1 and type 2 diabetes were examined separately. Study variability and poor reporting made comparison difficult, and most studies had important methodological weaknesses. Evidence on the effectiveness of mhealth interventions for diabetes was inconsistent for both types of diabetes and remains weak