Endocrine Abstracts

Introduction: Diabetes is a chronic condition causing morbidity and mortality globally, with a growing economic burden on healthcare systems. In the UK, 1 in 14 people have diabetes, with type 2 accounting for 90% of cases (1). Complications from poorly controlled diabetes are associated with increased socioeconomic costs and a reduced quality of life. Research has shown education and self-management are crucial in helping diabetic patients achieve metabolic control (1). Smartphones have become an influential platform providing feasible tools such as health-apps to deliver tailored support to enhance diabetic patients’ ability for self-management. GroHealth is a NHSX-certified digital health tool used to deliver educational and monitoring support to facilitate the development of skills and practices for maintaining good health.

Objectives: To assess self-reported outcomes of the GroHealth app amongst diabetic and prediabetic users.

Method: The EuroQol-5D (EQ-5D) questionnaire is a standardised tool used to measure health status for clinical and economic appraisal. GroHealth users completed the EQ-5D at baseline and 6 months after using the app. Users provided informed consent for use of their anonymised data for research purposes. Health index scores (HIS) and visual analogue scale (VAS) scores were calculated at baseline and 6 months for individuals with prediabetes and type 2 diabetes (T2DM). Descriptive statistics and multiple-regression models were utilised to assess changes in outcome measures and determine the driving variables for change in HIS.

Results: HIS are average values that reflect people’s preferences about their health state (1=full health, 0=moribund). There was a significant and clinically meaningful increase in mean HIS amongst app users between baseline (0.746 [SD 0.234]) and follow-up (0.792 [SD 0.224], P<0.001). The greatest change was observed in mean VAS score with percentage change of 18.3% improvement (baseline:(61.7 [SD 18.1]), follow-up:(73.0 [SD 18.8]), P<0.001). These VAS score improvements remained significant across age, gender, ethnicity, income, and diagnosis (prediabetes/T2DM). Baseline HIS, ethnicity and education variables were associated with significant changes in follow-up HIS (P<0.001).

Conclsion: This study provides evidence of significant positive effect on self-reported quality of life amongst people living with T2DM engaging with a digital health intervention. The improvements in the five dimensions of health, as described by the EQ-5D, are facilitated through access to education and monitoring support tools within the app. This provides an opportunity for healthcare professionals to incorporate NHS certified digital tools, such as GroHealth as part of the holistic management of patients.

References: (1) Bene. BA et al. BMJOpen2019;9:e025714