Hype, hype, hype and more hype. That is the best description of mobile health apps. A paper from the Agency for Healthcare Research & Quality finds that the research on diabetes management mobile apps indicates little value and the research is generally of poor quality. (AHRQ Brief) Because chronic disease accounts for a significant portion of health spending, makers of mobile health apps have claimed that their products could help patients manage those diseases more effectively, resulting in lower spending and better health outcomes. Diabetes has a high prevalence so it is a natural target for these apps. The researchers did a review of existing research and literature on mobile diabetes management apps and asked experts to rate some of the apps. The authors identified 15 studies on a total of 13 apps; four of the apps were versions of free/paid products. Six of the studies were in regard to Type 1 diabetes, 5 in regard to Type 2. The apps typically measured blood glucose, Hb1Ac values, medication use, physical activity and/or weight. Most of the trials had a 2 to 12 month duration.
There was marginal improvement in HbA1c values in a few of the studies, caveated with the comments on study design below. There were no improvements in quality of life scores, blood pressure measures, weight or body mass index. Even there paltry results were deemed untrustworthy due to generally poor study design, including difficulty in ascertaining if any effect was due to the use of the app or to other features of care, like coaching and education. The researchers also asked experts to evaluate the usability of eight of the apps. Three were judged acceptable, two marginal and three deemed to be unacceptable. This is about exactly what I would expect. No one who really thinks about human behavior and managing health and health care would really believe that some stupid app on a phone is going to make much difference. Investors, however, apparently haven’t wised up yet. They will when plans, patients and advertisers stop providing revenue.