Efficacy of the Smartphone-Based Glucose Management Application Stratified by User Satisfaction

Background: We aimed to assess the efficacy of the smartphone-based health application for glucose control and patient satisfaction with the mobile network system used for glucose self-monitoring. Methods: Thirty-five patients were provided with a smartphone device, and self-measured blood glucose data were automatically transferred to the medical staff through the smartphone application over the course of 12 weeks. The smartphone user group was divided into two subgroups (more satisfied group vs. less satisfied group) based on the results of questionnaire surveys regarding satisfaction, comfort, convenience, and functionality, as well as their willingness to use the smartphone application in the future. The control group was set up via a review of electronic medical records by group matching in terms of age, sex, doctor in charge, and glycated hemoglobin (HbA1c). Results: Both the smartphone group and the control group showed a tendency towards a decrease in the HbA1c level after 3 months (7.7%+/- 0.7% to 7.5%+/- 0.7%, P=0.077). In the more satisfied group (n=27), the HbA1c level decreased from 7.7%+/- 0.8% to 7.3%+/- 0.6% (P=0.001), whereas in the less satisfied group (n=8), the HbA1c result increased from 7.7%+/- 0.4% to 8.1%+/- 0.5% (P=0.062), showing values much worse than that of the no-smartphone control group (from 7.7%+/- 0.5% to 7.7%+/- 0.7%, P=0.093). Conclusion: In addition to medical feedback, device and network-related patient satisfaction play a crucial role in blood glucose management. Therefore, for the smartphone app-based blood glucose monitoring to be effective, it is essential to provide the patient with a well-functioning high quality tool capable of increasing patient satisfaction and willingness to use.