Role of Digital Engagement in Diabetes Care Beyond Measurement: Retrospective Cohort Study
| Autor: | Pavel Goldstein, Eitan Feniger, Yifat Fundoiano-Hershcovitz, Abigail Hirsch, Sharon Dar |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Gerontology
self-management 020205 medical informatics Endocrinology Diabetes and Metabolism Biomedical Engineering 030209 endocrinology & metabolism Health Informatics 02 engineering and technology Type 2 diabetes lcsh:Diseases of the endocrine glands. Clinical endocrinology 03 medical and health sciences 0302 clinical medicine Health Information Management Diabetes mellitus 0202 electrical engineering electronic engineering information engineering blood glucose Medicine mHealth Original Paper Self-management lcsh:RC648-665 diabetes business.industry Glucose Measurement Retrospective cohort study digital engagement medicine.disease Digital health Computer Science Applications Mood business |
| Zdroj: | JMIR Diabetes, Vol 6, Iss 1, p e24030 (2021) JMIR Diabetes |
| ISSN: | 2371-4379 |
| Popis: | Background The use of remote data capture for monitoring blood glucose and supporting digital apps is becoming the norm in diabetes care. One common goal of such apps is to increase user awareness and engagement with their day-to-day health-related behaviors (digital engagement) in order to improve diabetes outcomes. However, we lack a deep understanding of the complicated association between digital engagement and diabetes outcomes. Objective This study investigated the association between digital engagement (operationalized as tagging of behaviors alongside glucose measurements) and the monthly average blood glucose level in persons with type 2 diabetes during the first year of managing their diabetes with a digital chronic disease management platform. We hypothesize that during the first 6 months, blood glucose levels will drop faster and further in patients with increased digital engagement and that difference in outcomes will persist for the remainder of the year. Finally, we hypothesize that disaggregated between- and within-person variabilities in digital engagement will predict individual-level changes in blood glucose levels. Methods This retrospective real-world analysis followed 998 people with type 2 diabetes who regularly tracked their blood glucose levels with the Dario digital therapeutics platform for chronic diseases. Subjects included “nontaggers” (users who rarely or never used app features to notice and track mealtime, food, exercise, mood, and location, n=585) and “taggers” (users who used these features, n=413) representing increased digital engagement. Within- and between-person variabilities in tagging behavior were disaggregated to reveal the association between tagging behavior and blood glucose levels. The associations between an individual’s tagging behavior in a given month and the monthly average blood glucose level in the following month were analyzed for quasicausal effects. A generalized mixed piecewise statistical framework was applied throughout. Results Analysis revealed significant improvement in the monthly average blood glucose level during the first 6 months (t=−10.01, P Conclusions This study sheds light on the source of the association between user engagement with a diabetes tracking app and the clinical condition, highlighting the importance of within-person changes versus between-person differences. Our findings underscore the need for and provide a basis for a personalized approach to digital health. |
| Databáze: | OpenAIRE |
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