Summary: In a randomised trial in mostly older primary-care patients with diabetes, an individualised eHealth chronic-disease module improved HbA1c at 4 months and got more patients to target, but app usage fell substantially by 8 months, tempering the durability of benefit.
PICO Summary
| Element | Detail |
|---|---|
| Population | 165 randomised (161 analysed) primary-care patients with chronic disease including diabetes, mean age ~66; RCT, Hong Kong. |
| Intervention | Individualised eHealth app with a chronic-disease management module for tracking and care facilitation (n=83). |
| Comparison | Standard care without the module (n=82). |
| Outcome | At 4 months the intervention group had lower HbA1c (6.76% vs 7.09%; p=0.007) and more reached optimal HbA1c (73.4% vs 49.3%; p=0.004). App usage declined significantly between month 4 and month 8 (p<0.001); the authors note adherence was key to sustained control. |
eHealth app for glycemic control
RCT · type 2 diabetes · 8 months
At 4 months the app group was far more likely to reach optimal HbA1c (73.4% vs 49.3%), but usage fell sharply by 8 months, so durability is uncertain.
Expert Commentary
This is a clear-eyed digital-health trial whose value lies as much in its disappointment as in its success. The early signal is genuinely good: a 0.33% HbA1c advantage at four months is in line with the better mobile-health evidence, and the jump in patients reaching target, from roughly half to nearly three quarters, is clinically worthwhile. But the study’s honesty about what happened next is what makes it useful, app usage fell markedly by month eight, and the authors are candid that adherence drove the benefit. This is the recurring Achilles heel of digital health, the novelty fades and daily routines reassert themselves, so a four-month win may not hold. I would also note the population was older and had mixed chronic conditions rather than diabetes alone, which both encourages, since these patients did engage initially, and cautions against over-extrapolation. Can I use this with my patients? Yes, as an adjunct with realistic expectations. I would offer an evidence-based app as one component of diabetes care rather than a standalone fix, build in periodic check-ins on usage, and match the tool to the patient’s digital comfort, while keeping regular clinical follow-up and medication optimisation central.
References
Huang J, Zhong CC, Wong SH, Lo CY, Yim MK, Wong MCS. eHealth applications improve glycemic control in patients with diabetes: randomized controlled trial. JMIR Form Res. 2025;9:e67761. doi:10.2196/67761