WellDoc Diabetes management application
In healthcare, knowledge is constructed by responding to the discoveries and ideas of early professionals. For healthcare researchers to do so, they need to review studies done by others. Those studies should be unique and ensure content presented is verifiable. The sources of facts, notions, and methods utilized to arrive at conclusions and insights should be provable. Scholarly articles meet this criterion since most of them are peer-reviewed. Meaning experts in the medical field other than the authors and editors of the journals and articles check their contents before publication. By doing so, experts ensure that new content is presented in the context of what is already known, the methods used are the right ones, and that articles contribute to building knowledge in healthcare. The purpose of this assignment is to conduct an in-depth analysis of journals and articles that discuss the use of mobile health applications in the management of chronic illnesses. In the previous assignment, three stakeholders presented their opinions about the WellDoc diabetes management application. A patient with type II diabetes, a nurse manager in a diabetic clinic, and a family nurse practitioner were involved. Their responses guide me in the literature search for this assignment.
Depiction of the search criteria
Individuals living with chronic illnesses require substantial support to ensure effective lifestyle modifications. Self-management is an essential aspect of chronic disease management, including modification in diet, physical activity, and drug adherence. Technology has made this possible since mobile health apps have been designed to enhance patients’ self-management. Dolan (2010) cites that WellDoc diabetes management app has been granted clearance by the Food and Drug Administration (FDA) to be used by healthcare providers and persons with type II diabetes. WellDoc app is built on programmed clinical coaching and behavioral systems which are driven by real-time patients’ data (Dolan, 2010). Besides, the mobile application enables healthcare providers to attend to their patients from their homes rather than the traditional office visits by the use of mobile phones and internet. The key words used in the literature search were diabetes, self-management, mobile health, and pdf. By using these key words, accessing scholarly articles related to this topic was possible.
In the previous week’s assignment, the interview with the involved stakeholders influenced my literature search. The patient interviewed said that the mobile application has had significant results on his self-management skills. He also stated that he would recommend the application to every patient suffering from diabetes type II. However, the patient pointed out the challenges he encountered in using the app. His opinions influenced the use of key words, including the benefits of using WellDoc app, self-management, mobile health applications, and shortcomings of mobile health applications. The unit manager of the diabetes clinic was concerned about the privacy of data and back-up plans for data in the application. So, her opinions influenced the use of key words such as mobile health applications, safety, and privacy of data.
Databases
Evidence-based databases are crucial for accessing credible sources of information. For the completion of the matrix table, PubMed, MEDLINE, and Google Scholar were used to access journals for literature review. The three utilized databases provided access to scholarly and peer-reviewed articles and journals, which were up-to-date and focused on the chosen topic. Besides, the databases utilized allow their users to access materials at no cost.
The matrix table 1 illustrates the five peer-reviewed articles published between 2010 and 2020. All the materials used are related to the use of mobile health applications in the management of chronic illnesses, especially patient self-management. The articles present diverse information from disciplines such as health information technology and healthcare, which are pertinent to the practice of a nurse practitioner.
A summary of the articles
The main theme in the five articles in the matrix is the effectiveness of mobile health applications in the management of chronic diseases and privacy concerns when using mobile health applications. Chomutare et al., (2011) conducted a study on the significant features of diabetes self-management mobile health applications to determine their congruency with clinical guidelines for diabetes management. Pham et al., (2019) conducted a literature review to determine how analytical gauges of patient engagement have been applied in clinical and technological settings to enlighten their application in future. Whitehead & Seaton (2016) conducted a systematic review to assess the effectiveness of mobile health applications in the management of chronic diseases. These articles are significant in informing healthcare professionals on what applications meet the clinical criteria for the management of chronic illnesses, including diabetes. It is important to note that specific features should be a characteristic of mobile health applications to enhance patient self-management, including health education as seen in WellDoc diabetes management application. Therefore, it helps in preventing complications such as chronic kidney disease and retinopathy. While Langarizadeh et al., (2017) reviewed articles to detect ethical issues, including patient privacy and the role of telemedicine in enhancing healthcare services. The material on privacy and patient data safety inform healthcare providers about the barriers to using mobile health applications such as privacy concerns. Confidentiality of patients’ data is an ethical issue in healthcare which should be upheld.
References
Chomutare, T., Fernandez-Luque, L., Årsand, E., & Hartvigsen, G. (2011). Features of mobile diabetes applications: review of the literature and analysis of current applications compared against evidence-based guidelines. Journal of medical Internet research, 13(3), e65. https:// DOI: 10.2196/jmir.1874
Dolan, B. (2010). FDA clears WellDoc for diabetes management.
Langarizadeh, M., Moghbeli, F., & Aliabadi, A. (2017). Application of ethics for providing telemedicine services and information technology. Medical Archives, 71(5), 35. https:// doi: 10.5455/medarh.2017.71.351-355
Pham, Q., Graham, G., Carrion, C., Morita, P. P., Seto, E., Stinson, J. N., & Cafazzo, J. A. (2019). A library of analytic indicators to evaluate effective engagement with consumer mHealth apps for chronic conditions: scoping review. JMIR mHealth and uHealth, 7(1), e11941. https
Whitehead, L., & Seaton, P. (2016). The effectiveness of self-management mobile phone and tablet apps in long-term condition management: a systematic review. Journal of medical Internet research, 18(5), e97. https:// doi:10.2196/jmir.4883
| Source citation | Purpose | Design | Instruments/ measurements | Results | Strengths and weaknesses |
| Chomutare, T., Fernandez-Luque, L., Årsand, E., & Hartvigsen, G. (2011). Features of mobile diabetes applications: review of the literature and analysis of current applications compared against evidence-based guidelines. Journal of medical Internet research, 13(3), e65. https:// DOI: 10.2196/jmir.1874
| To study the relevant features of mobile apps for diabetes care in relation to clinical guideline approvals for diabetes self-management as published by health authorities such as the American Diabetes Association. | Researchers reviewed online vendor markets for Apple IPhones, BlackBerry, and Android devices, journals, and gray literature for apps related to diabetes and self-management.
The researchers reviewed 137 mobile applications | The researchers installed the apps that met their selection criteria and verified the functionality in a spreadsheet. For those that were not able to be installed, the researchers cross-referenced the utility descriptions in published journals. | Out of the 137 applications reviewed, 65% had features for tracking insulin and other diabetes medication, over 50% had features for diet management, and 40% had physical activity and 39% had weight tracking features. | Strengths The study included all mobile health apps in literature and vendor markets.
Weakness Many of the apps outside the official online stores were not available for installation and were only described based on existing literature.
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| Pham, Q., Graham, G., Carrion, C., Morita, P. P., Seto, E., Stinson, J. N., & Cafazzo, J. A. (2019). A library of analytic indicators to evaluate effective engagement with consumer mHealth apps for chronic conditions: scoping review. JMIR mHealth and uHealth, 7(1), e11941. https
| To combine how analytic indicators of engagement have in mobile health have been applied across clinical and technological contexts, to inform how they might be optimally applied in future assessments | The researchers conducted a scoping review to list the range of analytic indicators being used in evaluations of consumer mHealth apps for chronic conditions. A total of 41 articles met the inclusion criteria. | Evaluation of apps included a two-group pretest-posttest randomized controlled experimental study of a hybrid-structured app for chronic disease self-management | Out of the 41 applications, 76% showed the frequency of interactions by the user, 73% showed features accessed, 49% showed number of log-ins and number of lessons completed or started. | Strengths Researchers measured on average 3 indicators in every application weakness Findings did not further investigate how engagement with an application supported health and well-being of patients. |
| Whitehead, L., & Seaton, P. (2016). The effectiveness of self-management mobile phone and tablet apps in long-term condition management: a systematic review. Journal of medical Internet research, 18(5), e97. https:// doi:10.2196/jmir.4883
| To evaluate the effectiveness of mobile apps in self-management chronic conditions | The researchers searched PubMed, Embase, EBSCO Cochrane Library databases for randomized controlled trials that evaluated the effectiveness of mobile health apps in self-management of diabetes, cardiovascular diseases, and chronic diseases. The researchers reviewed nine papers. | The researchers used Boolean phrases to search for articles in the databases and reported their findings using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). | Out of the nine articles reviewed, six demonstrated a significant improvement in clinical outcomes of patients. Where interventions were using an application only, 5/9 demonstrated significant improvement in the management of diabetes mellitus, 3/9 chronic lung disease, and 1/9 showed a significant improvement of clinical outcomes for patients with cardiovascular illnesses. | Strengths The study focused on the effectiveness of mobile health application in the management of several chronic diseases. weakness the study designs used are heterogeneous, so, a meta-analysis was not possible. Only literature written in English was reviewed, thus, some information may have been missed. |
| Langarizadeh, M., Moghbeli, F., & Aliabadi, A. (2017). Application of ethics for providing telemedicine services and information technology. Medical Archives, 71(5), 351 https:// doi: 10.5455/medarh.2017.71.351-355 | To detect ethical issues in the provision of telemedicine services. | Data for the research was obtained from credible academic articles and published electronic sources. 28 articles met the eligible criteria for the research. | The researchers utilized databases, including PubMed, Scopus and Science Direct in the search for relevant information related to the topic. The information gathered was analyzed using the comparative analysis method. | For the 28 articles reviewed, 8 showed that advanced technology increased the significance of ethical issues, 7 demonstrated the need for increased attention to confidentiality and data security, 6 showed that telemedicine disrupted provider-patient relationship, and seven showed that there is need for informed consent before prescribing a mobile health app for a patient. | Strengths The study focused on all ethical issues in medicine apart from data security and confidentiality. weaknesses the researchers utilized only 28 sources, thus, a small sample size for investigating ethical issues in telemedicine. |