Development and user acceptability testing of healthy heart mobile application – a tool for cardiovascular risk modification among patients with type 2 diabetes mellitus

Prithviraj Erande; Ipseeta Ray Mohanty; Sandeep Rai

doi:10.1515/jbcpp-2023-0073

Article

Development and user acceptability testing of healthy heart mobile application – a tool for cardiovascular risk modification among patients with type 2 diabetes mellitus

Prithviraj Erande , Ipseeta Ray Mohanty and Sandeep Rai

Published/Copyright: November 7, 2023

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From the journal Journal of Basic and Clinical Physiology and Pharmacology Volume 34 Issue 6

Abstract

Objectives

Cardiovascular disease (CVD) remains the primary cause of mortality in individuals with type 2 diabetes mellitus. Digital health has quickly emerged as a technology with the ability to bridge the gap in cardiovascular disease self-management and revolutionize the way healthcare has traditionally been delivered. However, there is little data on the application of mobile technologies for cardiovascular risk reduction among diabetic patients. The current study has been constructed with this in mind.

Methods

A framework for the development of a healthy heart mobile application for CVD risk stratification and risk management among Type 2 diabetes mellitus patients was finalized after consultation with diabetologists, nutritionists, and scientists. The mobile app has three user cases: Patient login, doctor login, and admin login. A questionnaire was designed and the feedback of patients and Physicians was taken regarding the design, presentation, content, and user-friendliness of the app based on responses obtained on the questionnaire.

Results

The Android version of the healthy heart mobile mobile app was developed for CVD risk stratification and risk management among type 2 diabetes mellitus patients. The dashboard of the mobile app displayed the CVD risk score and category (mild, moderate, high, or very high CVD risk; which was colored coded), health tracker to monitor medication adherence, lipid profile, diabetes control, CVD risk profile and compliance with the WHO recommendations regarding diet, physical activity and addictions, User acceptability and experience were tested for the developed healthy heart mobile app among patients and physicians. The majority of the respondents graded the design, presentation, content, and user-friendliness of the app as either excellent or good.

Conclusions

The mobile app for self-management and CVD risk reduction among diabetic patients was successfully developed. The paper and mobile-based CVD risk calculation and stratification were found to be a match for all the participants. The app was updated based on suggestions from the pilot study and was well-accepted by both patients and physicians.

Keywords: cardiovascular diseases; mobile app; type 2 diabetes mellitus

Corresponding author: Dr. Ipseeta Ray Mohanty, Professor, Department of Pharmacology, MGM Institue of Health Sciences, Kamothe, Navi Mumbai, Maharashtra, 410209, India, Phone: +91-9819908498, Fax: +91-2256661988, E-mail: ipseetamohanty@yahoo.co.in, Institutional: www.mgmuhs.com

Funding source: Indian Council of Medical Research

Award Identifier / Grant number: 2019-0502

Acknowledgments

Dr. Priyanka Pareek HOD Dept of Clinical Nutrition MGM School of Biomedical Sciences, Kamothe, Navi Mumbai

Research ethics: The study was conducted in accordance with the Declaration of Helsinki (as revised in 2013). Necessary Institutional Ethics Committee’s Approval was obtained before initiating the study. Name of IEC: MGM Institute of Health Sciences, Kamothe, Navi Mumbai. Approval No: MGMIHS/RES./02/2020-21/72.
Informed consent: Informed consent was obtained from all individuals included in this study, or their legal guardians or wards.
Author contributions: The authors have accepted responsibility for the entire content of this manuscript and approved its submission. Mr. Prithviraj Erande: Researcher, Protocol Design, Data Collection, Analysis, Manuscript Writing and submission. Dr. Ipseeta Ray: Corrosponding Author, Guidance, Protocol Design, Analysis, Manuscript reviewing. Dr. Sandeep Rai: Co-Guidance, Protocol Design, Manuscript Reviewing.
Competing interests: The authors state no conflicts of interest.
Research funding: Study is funded by Indian council of Medical Research (ICMR), Government of India. Approval No: 2019-0502.
Data availability: The raw data can be obtained on request from the corresponding author.

References

1. Gulayin, P, Irazola, V, Lozada, A, Chaparro, M, Santero, M, Gutierrez, L, et al.. An educational intervention to improve effectiveness in treatment and control of patients with high cardiovascular risk in low-resource settings in Argentina: study protocol of a cluster randomized controlled trial. BMJ Open 2017;7:014420. https://doi.org/10.1136/bmjopen-2016-014420.Search in Google Scholar PubMed PubMed Central

2. Khan, N, Marvel, FA, Wang, J, Martin, SS. Digital health technologies to promote lifestyle change and adherence. Curr Treat Options Cardiovasc Med 2017;19:60. https://doi.org/10.1007/s11936-017-0560-4.Search in Google Scholar PubMed

3. Berwanger, O, Piva, LA, Martin, FV, Lopes, R, Figueiredo, E, Magnoni, D, et al.. Evidence-based therapy prescription in high-cardiovascular risk patients: the REACT study. Arq Bras Cardiol 2013;100:212–20. https://doi.org/10.5935/abc.20130062.Search in Google Scholar PubMed

4. Fox, CS, Coady, S, Sorlie, PD, D’Agostino, RB, Michael, JP, Vasan, RS, et al.. Increasing cardiovascular disease burden due to diabetes mellitus: the Framingham Heart Study. Circulation 2007;115:1544–50. https://doi.org/10.1161/circulationaha.106.658948.Search in Google Scholar

5. UK Prospective Diabetes Study (UKPDS). Group effect of intensive blood glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). Lancet 1998;352:854–65.10.1016/S0140-6736(98)07037-8Search in Google Scholar

6. Surka, S, Edirippulige, S, Steyn, K, Gaziano, T, Puoane, T, Levitt, N. Evaluating the use of mobile phone technology to enhance cardiovascular disease screening by community health workers. Int J Med Inf 2014;83:648–54. https://doi.org/10.1016/j.ijmedinf.2014.06.008.Search in Google Scholar PubMed PubMed Central

7. World Health Organization (WHO). HEARTS technical package for cardiovascular disease management in primary health care: risk based CVD management. Geneva: World Health Organization; 2020. Licence: CC BY-NC-SA 3.0 IGO.Search in Google Scholar

8. Einarson, TR, Acs, A, Ludwig, C, Panton, UH. Prevalence of cardiovascular disease in type 2 diabetes: a systematic literature review of scientific evidence from across the world in 2007–2017. Cardiovasc Diabetol 2018;17:2–19. https://doi.org/10.1186/s12933-018-0728-6.Search in Google Scholar PubMed PubMed Central

9. Ordúñez, P, Tajer, C. Disseminating cardiovascular disease risk assessment with a PAHO mobile app: a public eHealth intervention in 2015. Pan Am J Public Health 2015;38:82–5.Search in Google Scholar

10. Milne-Ives, M, Lam, C, De Cock, C, Van Velthoven, MH, Meinert, E. Mobile apps for health behavior change in physical activity, diet, drug and alcohol use, and mental health: systematic review. JMIR mHealth uHealth 2020;8:2–16. https://doi.org/10.2196/17046.Search in Google Scholar PubMed PubMed Central

11. Buss, VH, Varnfield, M, Harris, M, Barr, M. A mobile app for prevention of cardiovascular disease and type 2 diabetes mellitus: development and usability study. JMIR Hum Factors 2022;9:1–20. https://doi.org/10.2196/35065.Search in Google Scholar PubMed PubMed Central

12. Ordunez, P, Tajer, C, Gaziano, T, Rodriguez, YA, Rosende, A, Jaffe, MG. The Hearts App: a clinical tool for cardiovascular risk and hypertension management in primary health care. Rev Panam Salud Públic 2022;46:1. https://doi.org/10.26633/rpsp.2022.12.Search in Google Scholar

13. Doupis, J, Festas, G, Tsilivigos, C, Efthymiou, V, Kokkinos, A. Smartphone-based technology in diabetes management. Diabetes Ther 2020;11:607–19. https://doi.org/10.1007/s13300-020-00768-3.Search in Google Scholar PubMed PubMed Central

14. Palermi, S, Iacono, O, Sirico, F, Modestino, M, Ruosi, C, Spera, R, et al.. The complex relationship between physical activity and diabetes: an overview. Berlin, Boston: De Gruyter; 2022, 33.10.1515/jbcpp-2021-0279Search in Google Scholar PubMed

15. Palermi, S, Sacco, AM, Belviso, I, Romano, V, Montesano, P, Corrado, B, et al.. Guidelines for physical activity—a cross-sectional study to assess their application in the general population. Have we achieved our goal? MDPI 2020;17:3980–94. https://doi.org/10.3390/ijerph17113980.Search in Google Scholar PubMed PubMed Central

16. Vecchiato, M, Zanardo, E, Battista, F, Quinto, G, Bergia, C, Palermi, S, et al.. The effect of exercise training on irisin secretion in patients with type 2 diabetes: a systematic review. MDPI 2022;12:1–14. https://doi.org/10.3390/jcm12010062.Search in Google Scholar PubMed PubMed Central

17. Palermi, S, Vecchiato, M, Pennella, S, Marasca, A, Spinelli, A, Luca, MD, et al.. The impact of the COVID-19 pandemic on childhood obesity and lifestyle—a report from Italy. MDPI 2022;14:410–8. https://doi.org/10.3390/pediatric14040049.Search in Google Scholar PubMed PubMed Central

Received: 2023-04-17

Accepted: 2023-10-13

Published Online: 2023-11-07

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Articles in the same Issue

https://doi.org/10.1515/jbcpp-2023-0073

Keywords for this article

cardiovascular diseases; mobile app; type 2 diabetes mellitus