Dropping out of mobile apps has health consequences

Western Sydney Diabetes research, monitoring and surveillance coordinator Gideon Meyerowitz-Katz.

A new study by Western Sydney Diabetes has found nearly half of people who use mobile phone apps to monitor their chronic disease stop using the apps quickly – but those who persist get great benefits.

Gideon Meyerowitz-Katz is the research, monitoring and surveillance coordinator at Western Sydney Diabetes, a collaborative initiative led by Western Sydney Local Health District and Western Sydney Primary Health Network (WentWest) to address the Western Sydney diabetes hotspot.

He said apps such as CareMonitor and Health2Sync have become one of the most talked-about medical interventions for chronic diseases like diabetes.

“This is not only because they are flashy and cool, but because they hold such enormous promise. You can make an app for a fraction of the cost of traditional medical care and potentially reach millions of users,” Mr Meyerowitz-Katz said.

“So a huge number of apps have sprung up across the world to manage and treat chronic disease, because when we have new and flashy things, we want to try them on every problem to see if they work.”

However, Mr Meyerowitz-Katz said the problem is that people don’t tend to use apps for very long.

Many people experiment with apps to conveniently track their diet.

“This is a problem when we’re thinking of using them for diseases that last a lifetime,” he said.

“If people only use the app for a month or two, then it’s not going to help very much with diabetes that may never go away.”

To investigate, WSD conducted a systematic review and meta-analysis into dropout in apps for chronic disease.

After combing through about 1000 studies, the team included 34 pieces of research and aggregated their results.

“What we found was a bit depressing – but perhaps not unsurprising – which is that people who use apps drop out at a rate of about 43 per cent,” Mr Meyerowitz-Katz said.

“This is quite high. On top of this, even the people who keep using apps often do so at levels far below those required to get a benefit – some people only log in once or twice a year.

“It’s hard to improve your chronic disease when you’re only using the treatment once every six months.

“What this means is that apps have a huge problem, but also a huge opportunity.”

Mr Meyerowitz-Katz said they also found evidence that linking these apps in with traditional care improved their use, and that there may be other ways to stop people from dropping out.

“In many ways, this makes apps just like regular medical care, because as evidence shows many people also, for example, stop taking their medications quite soon after they are prescribed,” he said.

“And in the case of apps, despite the large dropout rates that we found in our study, many of the included pieces of research had positive results.

“In other words, even though many people didn’t use the app, the people who did had large enough benefits that the whole group looked positive, on average.

“So the take-home from our research is twofold: firstly, that people drop out of apps a lot, but secondly that apps are also very useful for the people that keep using them, and if we work to improve apps they may yet live up to their promise.”

For more information about the research or Western Sydney Diabetes, call (02) 8670 7770 or email WSLHD-WSDiabetes@health.nsw.gov.au.