Health outcomes following engagement with a digital health tool GroHealth app amongst people with prediabetes and type 2 diabetes (Preprint)

BACKGROUND Diabetes is a chronic condition causing morbidity and mortality globally, with a growing economic burden on healthcare systems. Complications from poorly controlled diabetes are associated with increased socioeconomic costs and a reduced quality of life. 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. OBJECTIVE To assess self-reported outcomes of the GroHealth app amongst diabetic and prediabetic users and identify the factors that determine engagement with the digital health tool. METHODS This was a service evaluation of self-reported data collected prospectively by the developers of the GroHealth digital tool. 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. EQ-5D index scores 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 the outcome measures and determine the factors that affected engagement with the digital tool. RESULTS EQ-5D index scores 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 EQ-5D index scores amongst app users between baseline (0.746 [SD 0.23]) and follow-up (0.792 (SD 0.22), P CONCLUSIONS 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, as demonstrated by the EQ-5D questionnaire, 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 people living with diabetes.