Patient-reported outcomes (R-Outcomes) and user experience following six months’ enrolment in a diabetes digital health service: My Diabetes My Way (Preprint)

BACKGROUND Diabetes eHealth platforms facilitate self-management and improve patient outcomes. Engagement relies on user experience/satisfaction. OBJECTIVE This study investigates how enrolment in a newly implemented eHealth platform (My Diabetes My Way (MDMW) Somerset) impacts upon patient-reported outcomes and experience. METHODS MDMW Somerset was implemented in June 2018. Users were invited to complete a PROMS/PREMs questionnaire (R-Outcomes) at enrolment and 6 months, covering 7 domains (Health status, Health confidence, Wellbeing, Service integration, Self-care, Digital confidence and User experience) with 4 items in each domain and 4 options each. Before-after comparison used Wilcoxon signed-rank tests and Generalised Equation Modelling; free-text data were analysed thematically. RESULTS Respondents’ (N=483) mean age was 67 years (SD 9.8, range 25-91). 331/483 (69%) male, 432/483 (89%) T2D. One PROM item, ‘I know enough about my health’, significantly improved at follow-up compared with baseline, while five PROM items (pain or discomfort, I can get the right help, I am satisfied with my life, I was happy yesterday, new ideas are needed in healthcare) and four service integration items declined. Domain scores also declined. Free-text comments identified issues with log-in, local health data links and factors unrelated to MDMW. Most respondents were ‘satisfied with the product’, thought it ‘helped them do what they wanted’ and was ‘easy to use’. Respondents described MDMW aiding self-management, with easy information access facilitating perceived control and behaviour change. CONCLUSIONS eHealth services aid self-management, but usability and access issues can impact use/satisfaction. Deteriorating PROMs alongside positive user experience suggest that factors outside the platform’s control are important. This study identifies a number of areas where improvements could enhance user engagement.