Content Analysis: First-Time Patient User Challenges with Top-Rated Commercial Diabetes Apps

Helen N Fu, Diana Jin, Terrence J. Adam

Research output: Contribution to journalArticlepeer-review


Background/Introduction: Using a mobile application (app) may improve diabetes self-management. However, the use of diabetes apps is low, possibly due to design and usability issues. The purpose of this study was to identify barriers to app use among adult patients with diabetes who were testing diabetes apps for the first time. Materials and Methods: We conducted a content analysis of observation notes and patient comments collected during the testing of two top commercially available diabetes apps as part of a crossover randomized trial. Participants were adult patients with type 1 or type 2 diabetes on insulin therapy. We analyzed field notes and transcriptions of audio recordings. Open coding derived categories of usability issues, which then were grouped into themes and subthemes on usability problem types. Results: A total of 92 adult Android smartphone users were recruited online (e.g., Facebook) and in-person postings. Three major themes described problems with data input, app report display and presentation, and self-learning options. Data entry modes were problematic because of overcrowded app screens, complicated "save data"steps, and a lack of data entry confirmation. The app icons, wording, entry headings, and analysis reports were not intuitive to understand. Participants wanted self-learning options (e.g., pop-up messages) during app use. Conclusions: Patient testing of top commercially available diabetes apps revealed key usability design issues in data entry, app report, and self-help learning options. Good app training for patients is necessary for both initial use and long-term use of diabetes apps to support self-management.

Original languageEnglish (US)
Pages (from-to)663-669
Number of pages7
JournalTelemedicine and e-Health
Issue number6
StatePublished - Jun 1 2021

Bibliographical note

Funding Information:
This study was supported by the Robert Wood Johnson Foundation Future of Nursing and Sigma Theta Tau International—Zeta Chapter.

Publisher Copyright:
© Copyright 2021, Mary Ann Liebert, Inc., publishers 2021.


  • app testing
  • content analysis
  • diabetes app
  • m-health
  • telemedicine
  • usability
  • user interface

PubMed: MeSH publication types

  • Journal Article
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't


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